Provider Demographics
NPI:1548891211
Name:LUTES, DAWN MARIE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:LUTES
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8415 S EASTERN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2890
Mailing Address - Country:US
Mailing Address - Phone:725-204-5809
Mailing Address - Fax:725-204-7039
Practice Address - Street 1:8415 S EASTERN AVE STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2890
Practice Address - Country:US
Practice Address - Phone:725-204-5809
Practice Address - Fax:725-204-7039
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ266683363L00000X
NV827724363LW0102X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health