Provider Demographics
NPI:1154032506
Name:DAWES, AGNES DELORES (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:DELORES
Last Name:DAWES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WESTHAMPTON STA
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3330
Mailing Address - Country:US
Mailing Address - Phone:804-287-4200
Mailing Address - Fax:804-282-4048
Practice Address - Street 1:400 WESTHAMPTON STA
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3330
Practice Address - Country:US
Practice Address - Phone:804-287-4200
Practice Address - Fax:804-282-4048
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185275363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care