Provider Demographics
NPI:1962929711
Name:MCINTOSH, DAWNELL EDETTE (DNP, ARNP)
Entity type:Individual
Prefix:MRS
First Name:DAWNELL
Middle Name:EDETTE
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2282 AAA COURT
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1009
Mailing Address - Country:US
Mailing Address - Phone:563-341-7378
Mailing Address - Fax:800-861-9623
Practice Address - Street 1:2282 AAA COURT
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1009
Practice Address - Country:US
Practice Address - Phone:563-341-7378
Practice Address - Fax:800-861-9623
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA095388363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily