Individual
KACIE L DAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
319 E MADISON ST STE 1F, SPRINGFIELD, IL 62701-3118
(217) 545-8000
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.025658
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209.025658
IL
Other
Enumeration date
09/09/2022
Last updated
10/15/2024
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