Provider Demographics
NPI:1447786769
Name:AYERS, DAWN SERENE (FMHPNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:SERENE
Last Name:AYERS
Suffix:
Gender:F
Credentials:FMHPNP-BC
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:LITHERLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4004 BEL HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-2621
Mailing Address - Country:US
Mailing Address - Phone:315-935-9232
Mailing Address - Fax:
Practice Address - Street 1:4004 BEL HARBOR DR
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-2621
Practice Address - Country:US
Practice Address - Phone:315-935-9232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-05
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY516271163W00000X
NYF405921363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse