Provider Demographics
NPI:1487163218
Name:MAXWELL, DAWN MICHELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 N ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2616
Mailing Address - Country:US
Mailing Address - Phone:480-305-2888
Mailing Address - Fax:480-305-2889
Practice Address - Street 1:525 S WATSON RD
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-3449
Practice Address - Country:US
Practice Address - Phone:602-726-8750
Practice Address - Fax:623-925-0745
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10581363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care