Provider Demographics
NPI:1306816608
Name:MCCOOL, DAWN M B (CRNA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M B
Last Name:MCCOOL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE BAKER
Other - Last Name:MCCOOL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 2295
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-2295
Mailing Address - Country:US
Mailing Address - Phone:828-398-5244
Mailing Address - Fax:828-360-3080
Practice Address - Street 1:73-1296 ILAU ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-9333
Practice Address - Country:US
Practice Address - Phone:856-366-8404
Practice Address - Fax:808-323-3478
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN348193L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH56048Medicare PIN
PA027508Medicare ID - Type Unspecified
S80826Medicare UPIN
HIBE123ZMedicare PIN