# DAWN RENEE JEANNERAT

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

## Provider details

- **NPI number:** 1922471556
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | SP015559 | PA | Yes |

## Other

- **Enumeration date:** 11/04/2015
- **Last updated:** 05/05/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 103104610 | — | PA |
| 01 | — | PTAN | 462974 | PA |