Provider Demographics
NPI:1942769245
Name:PERRY, DAWN RENEE LYNN (RN, LAC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:RENEE LYNN
Last Name:PERRY
Suffix:
Gender:F
Credentials:RN, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5686 FREEPORT CT
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-5211
Mailing Address - Country:US
Mailing Address - Phone:614-203-2202
Mailing Address - Fax:
Practice Address - Street 1:528 S OTTERBEIN AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2913
Practice Address - Country:US
Practice Address - Phone:614-898-9195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-16
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN299361163WG0000X
OH65.000365171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice