Provider Demographics
NPI:1588545347
Name:ISRAEL, DAWN GREYEAGLE
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:GREYEAGLE
Last Name:ISRAEL
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 1:301 2ND AVE E
Mailing Address - Street 2:
Mailing Address - City:GACKLE
Mailing Address - State:ND
Mailing Address - Zip Code:58442-7121
Mailing Address - Country:US
Mailing Address - Phone:701-368-9060
Mailing Address - Fax:
Practice Address - Street 1:308 3RD AVE E
Practice Address - Street 2:
Practice Address - City:GACKLE
Practice Address - State:ND
Practice Address - Zip Code:58442-7125
Practice Address - Country:US
Practice Address - Phone:701-659-0923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home