Provider Demographics
NPI:1215915277
Name:KEY, DAWN WADDELL (NP)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:WADDELL
Last Name:KEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:3351 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-2587
Mailing Address - Country:US
Mailing Address - Phone:478-201-6500
Mailing Address - Fax:478-757-0876
Practice Address - Street 1:3351 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2587
Practice Address - Country:US
Practice Address - Phone:478-201-6500
Practice Address - Fax:478-757-0876
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN107136363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA50BBGGLMedicare PIN
GAP65540Medicare UPIN