Individual
IAN MATTHEW DAWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1215 S 1680 W, OREM, UT 84058-4939
(801) 342-5409
(801) 224-6010
Mailing address
841 W 1100 N, PLEASANT GROVE, UT 84062-9647
(801) 318-8869
(801) 224-6010
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
177817-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3005394
—
UT
01
—
70178
IDAHO APRN-CNP
ID
Enumeration date
08/16/2017
Last updated
08/10/2022
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