Dawn Deeter

Individual provider Active NPI Licensed Practical Nurse · Savona, NY

NPI 1487961728 · NPPES record last updated Sep 8, 2010

Key facts

NPI
1487961728
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
296594-1 (NY)
Practice address
105 E Lamoka Ave
Unit C
Savona, NY 14879-9714
Phone
(607) 329-1019
NPI assigned
Sep 8, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
296594-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 296594-1 NY Yes

Addresses

Primary practice location

105 E Lamoka Ave
Unit C
Savona, NY 14879-9714

Mailing address

105 E Lamoka Ave
Unit C
Savona, NY 14879-9714

Other providers in Savona, NY

All providers in Savona, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.