Provider Demographics
NPI:1306982350
Name:GALBREATH, DAWN MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARIE
Last Name:GALBREATH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 SW 9TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991
Mailing Address - Country:US
Mailing Address - Phone:239-458-3770
Mailing Address - Fax:239-458-3778
Practice Address - Street 1:1002 SW 9TH AVENUE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991
Practice Address - Country:US
Practice Address - Phone:239-458-3770
Practice Address - Fax:239-458-3778
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3141352163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL811231200Medicaid
FL3141352OtherRN LICENSE