Individual
NICHOLAS R DAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1010 SPRUCE ST 3RD FL AREA 1, ESPANOLA, NM 87532-2724
(505) 367-0340
(505) 367-0346
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(956) 566-3724
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2016-0070
NM
Other
Enumeration date
10/25/2016
Last updated
10/30/2024
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