Provider Demographics
NPI:1063717486
Name:EARL, DAWNA LOUISE (RN)
Entity type:Individual
Prefix:
First Name:DAWNA
Middle Name:LOUISE
Last Name:EARL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-1557
Mailing Address - Country:US
Mailing Address - Phone:330-337-7588
Mailing Address - Fax:
Practice Address - Street 1:291 W 9TH ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-1557
Practice Address - Country:US
Practice Address - Phone:330-337-7588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-15
Last Update Date:2011-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH269511163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse