Provider Demographics
NPI:1154518470
Name:DEAN, DAWN (PMHNP)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 COOKS LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-2016
Mailing Address - Country:US
Mailing Address - Phone:817-307-6209
Mailing Address - Fax:972-221-7901
Practice Address - Street 1:124 COOKS LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-2016
Practice Address - Country:US
Practice Address - Phone:817-307-6209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX680532363LP0808X
TXAP116293363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health