Provider Demographics
NPI:1871104356
Name:NOVAK, DAWN MICHELL
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELL
Last Name:NOVAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CABELL CT
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:25428-4010
Mailing Address - Country:US
Mailing Address - Phone:304-881-9235
Mailing Address - Fax:
Practice Address - Street 1:34 CABELL CT
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:WV
Practice Address - Zip Code:25428-4010
Practice Address - Country:US
Practice Address - Phone:304-881-9235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant