Individual
KEONA DAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
469 MIGEON AVE, TORRINGTON, CT 06790-4643
(860) 482-3038
Mailing address
469 MIGEON AVE, TORRINGTON, CT 06790-4643
(860) 482-3038
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
005941
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
5941
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356318091
—
CT
Enumeration date
01/03/2015
Last updated
12/05/2016
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