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Individual
DAWN A MAXIM
Active
Individual
DAWN A MAXIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3004330
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000814123
ANTHEM - NIS
KY
01
—
146607
SIHO-NIS
KY
05
—
200923230
—
IN
01
—
50050109
PASSPORT - NIS
KY
05
—
78012457
—
KY
Enumeration date
07/10/2006
Last updated
03/12/2018
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