Provider Demographics
NPI:1679520183
Name:LORAAS, DAWN R (NP-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:R
Last Name:LORAAS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4507
Mailing Address - Country:US
Mailing Address - Phone:701-530-6000
Mailing Address - Fax:701-530-6433
Practice Address - Street 1:1000 E ROSSER AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4414
Practice Address - Country:US
Practice Address - Phone:701-530-6000
Practice Address - Fax:701-530-6433
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR24812363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDP00111415OtherMEDICARE RAILROAD
ND19753Medicaid
NDS93388Medicare UPIN
ND23731Medicare ID - Type Unspecified
ND0857780001Medicare NSC