Provider Demographics
NPI:1962690313
Name:MONAHAN, DAWN S (APRN, BC)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:S
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:MISS
Other - First Name:DAWN
Other - Middle Name:LEE
Other - Last Name:SAWRUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-8082
Mailing Address - Country:US
Mailing Address - Phone:860-679-2100
Mailing Address - Fax:
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-8040
Practice Address - Country:US
Practice Address - Phone:860-679-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003644363LF0000X
CT3644363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology