Provider Demographics
NPI:1174732317
Name:CORRIGAN, DAWN MARIE (LPN)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2616
Mailing Address - Country:US
Mailing Address - Phone:631-475-0839
Mailing Address - Fax:
Practice Address - Street 1:59 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2616
Practice Address - Country:US
Practice Address - Phone:631-475-0839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260400-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse