Provider Demographics
NPI:1073845186
Name:GAY, DAWN MALISA (RN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MALISA
Last Name:GAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10448 KINGSBURY BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-1112
Mailing Address - Country:US
Mailing Address - Phone:216-647-5991
Mailing Address - Fax:
Practice Address - Street 1:10448 KINGSBURY BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-1112
Practice Address - Country:US
Practice Address - Phone:216-647-5991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH369079163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse