Provider Demographics
NPI:1215281043
Name:SPENCE, DAWNIA A (LPN)
Entity type:Individual
Prefix:MISS
First Name:DAWNIA
Middle Name:A
Last Name:SPENCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 BIVONA ST
Mailing Address - Street 2:APT 3C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-1414
Mailing Address - Country:US
Mailing Address - Phone:347-209-0309
Mailing Address - Fax:
Practice Address - Street 1:3550 BIVONA ST
Practice Address - Street 2:APT 3C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-1414
Practice Address - Country:US
Practice Address - Phone:347-209-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311567164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse