Provider Demographics
NPI:1477148617
Name:GRIESHOP, DAWN
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:GRIESHOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 N KUTHER RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-8678
Mailing Address - Country:US
Mailing Address - Phone:937-538-1017
Mailing Address - Fax:
Practice Address - Street 1:1601 N KUTHER RD
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-8678
Practice Address - Country:US
Practice Address - Phone:937-538-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide