Basic Information
Provider Information
NPI: 1275937963
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAWKINS
FirstName: LORRAINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 690 CANTON ST
Address2: SUITE 325
City: WESTWOOD
State: MA
PostalCode: 020902321
CountryCode: US
TelephoneNumber: 7814077713
FaxNumber: 7814070998
Practice Location
Address1: 690 CANTON ST
Address2: SUITE 325
City: WESTWOOD
State: MA
PostalCode: 020902321
CountryCode: US
TelephoneNumber: 7814077713
FaxNumber: 7814070998
Other Information
ProviderEnumerationDate: 10/09/2014
LastUpdateDate: 03/03/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN2296957MAN Nursing Service ProvidersRegistered Nurse 
367500000XRN2296957MAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home