Provider Demographics
NPI:1396463485
Name:VALDEZ, DAWN MARIE (FNP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5002
Mailing Address - Country:US
Mailing Address - Phone:970-317-7552
Mailing Address - Fax:
Practice Address - Street 1:1 MERCADO ST STE 160
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7309
Practice Address - Country:US
Practice Address - Phone:970-385-9850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997694-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily