Dawn Irene Blue

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

95012600 Issued in CA

Practice address

55887 Yucca Valley Trail
Yucca Valley, CA 92284

Phone

(760) 447-1200

NPI assigned

Sep 4, 2019

Last updated

Sep 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1821646746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60205 CHESAPEAKE DR",
            "city": "JOSHUA TREE",
            "state": "CA",
            "postal_code": "922522788",
            "telephone_number": "760-447-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55887 YUCCA VALLEY TRAIL",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "92284",
            "telephone_number": "760-447-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "DAWN",
        "middle_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95012600",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95012600",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95012600",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "391944",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy F Billings
• Jouise Black
• Bryan Paul Blackwell, CHC
• Stacey Michele Blackwell, CHC
• Blue Orthopedic Institute
• Julie K Botts
• Victoria Celeste Bourdon
• Harry J Bowkley
• Caren Estelle Brady, LCSW
• Mary Anne Braham

• Adult Health Nurse Practitioner in Yucca Valley, CA
• Providers in Yucca Valley, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.