Provider Demographics
NPI:1568814382
Name:DOWDELL, KRISTEN LOUISE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:LOUISE
Last Name:DOWDELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:KRISTEN
Other - Middle Name:LOUISE
Other - Last Name:CIPOLLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1049 SCARLET OAK DR APT D
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4542
Mailing Address - Country:US
Mailing Address - Phone:716-812-2722
Mailing Address - Fax:
Practice Address - Street 1:1049 SCARLET OAK DR APT D
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4542
Practice Address - Country:US
Practice Address - Phone:716-812-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006371RX363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical