Individual
MRS. DAWN MICHELLE BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, NP-C
Contact information
Practice address
1050 W 10TH ST, SUITE 350, ROLLA, MO 65401-2905
(573) 458-3350
Mailing address
1050 W 10TH ST, SUITE 350, ROLLA, MO 65401-2905
(573) 458-3350
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2004008434
MO
163W00000X
Registered Nurse
SD-RN R034321
SD
363LF0000X
Family Nurse Practitioner
Primary
2012035664
MO
363LF0000X
Family Nurse Practitioner
SD-CNP CP000610
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841515806
NPI BUSINESS
MO
01
—
272196402
TAX ID
MO
Enumeration date
04/26/2007
Last updated
05/13/2016
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