Provider Demographics
NPI:1568202661
Name:DAWSON, MICHELLE LAJANANE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LAJANANE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ATHENS WAY STE 240
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1311
Mailing Address - Country:US
Mailing Address - Phone:833-208-7770
Mailing Address - Fax:
Practice Address - Street 1:3200 SOUTHWEST FWY STE 2100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7525
Practice Address - Country:US
Practice Address - Phone:833-208-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX844632163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse