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Individual

MS. DAWN MARIE AYCOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-C

Contact information

Practice address
520 NE 542ND ST, OLD TOWN, FL 32680-3818
(863) 537-0644
Mailing address
520 NE 542ND ST, OLD TOWN, FL 32680-3818
(863) 537-0644

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
ARNP3191812
FL
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN3191812
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004615000
FL
Enumeration date
01/05/2012
Last updated
07/17/2019
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