Provider Demographics
NPI:1871782763
Name:SEWARD, DAWN MARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARIE
Last Name:SEWARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8559 CNTY HWY 27
Mailing Address - Street 2:TERESA RAWSON
Mailing Address - City:TROUT CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:13847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8559 CNTY HWY 27
Practice Address - Street 2:TERESA RAWSON
Practice Address - City:TROUT CREEK
Practice Address - State:NY
Practice Address - Zip Code:13847
Practice Address - Country:US
Practice Address - Phone:607-865-5597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2652601164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02559295Medicaid