# DAWN A MAXIM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1477587129
- **Gender:** F
- **Credential:** APRN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 3004330 | KY | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 03/12/2018

## 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 |