Provider Demographics
NPI:1366937229
Name:SUGG, DAWN RANAE (CNP)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:RANAE
Last Name:SUGG
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:MT
Mailing Address - Zip Code:59230-2313
Mailing Address - Country:US
Mailing Address - Phone:406-868-8177
Mailing Address - Fax:
Practice Address - Street 1:238 2ND AVE S
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:MT
Practice Address - Zip Code:59230-2313
Practice Address - Country:US
Practice Address - Phone:406-868-8177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-24
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT132085363LF0000X
MN5901363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1366937229Medicaid