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Individual
MRS. DAWN D STIDHAM
Active
Individual
MRS. DAWN D STIDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28191983A
IN
363L00000X
Nurse Practitioner
Primary
71005926A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201333360
—
IN
Enumeration date
09/30/2015
Last updated
11/18/2020
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