Provider Demographics
NPI:1306136742
Name:GLASS, DAWN MARIE (ANP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:GLASS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:ARAPAKOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 BOONE RIDGE DR
Mailing Address - Street 2:STE 201
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-8000
Mailing Address - Country:US
Mailing Address - Phone:423-282-1171
Mailing Address - Fax:423-282-1181
Practice Address - Street 1:411 PRINCETON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2049
Practice Address - Country:US
Practice Address - Phone:423-282-1171
Practice Address - Fax:423-282-1181
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN15781363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health