Provider Demographics
NPI:1306433990
Name:LUBAS, DAWN
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:LUBAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 KINGSTON DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1153
Mailing Address - Country:US
Mailing Address - Phone:419-975-8931
Mailing Address - Fax:
Practice Address - Street 1:2140 KINGSTON DR
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1153
Practice Address - Country:US
Practice Address - Phone:419-975-8931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker