Provider Demographics
NPI:1447844931
Name:DAWSON, HOLLY NICOLE (APRN)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:NICOLE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1578 GREENING DR
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-2313
Mailing Address - Country:US
Mailing Address - Phone:330-495-4212
Mailing Address - Fax:
Practice Address - Street 1:1578 GREENING DR
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-2313
Practice Address - Country:US
Practice Address - Phone:330-495-4212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily