1982913364 NPI number — MS. DAWN KEENA LIPSCOMBE NURSE PRACTITIONER

Table of content: MS. DAWN KEENA LIPSCOMBE NURSE PRACTITIONER (NPI 1982913364)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982913364 NPI number — MS. DAWN KEENA LIPSCOMBE NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIPSCOMBE
Provider First Name:
DAWN
Provider Middle Name:
KEENA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982913364
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7525 GREENWAY CENTER DRIVE
Provider Second Line Business Mailing Address:
SUITE T4
Provider Business Mailing Address City Name:
GREENBELT
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20770
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-345-2463
Provider Business Mailing Address Fax Number:
301-345-7653

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7525 GREENWAY CENTER DRIVE
Provider Second Line Business Practice Location Address:
SUITE T4
Provider Business Practice Location Address City Name:
GREENBELT
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-345-2463
Provider Business Practice Location Address Fax Number:
301-345-7653
Provider Enumeration Date:
10/01/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  R084686 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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