Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 103607 | IA |
NPI | 1043280639 |
---|---|
Provider Name | Mrs. Dawn M Sposato |
First Address | Ankeny, IA 50023-7004 |
Second Address | Ankeny, IA 50023-7004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 31/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10043280639 | (05) | IA |
Q52677 | (02) |