Provider Demographics
NPI:1578598322
Name:DAWSON, CAROLINE (CNP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-998-4575
Mailing Address - Fax:419-998-4586
Practice Address - Street 1:1005 BELLEFONTAINE AVE STE 340
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2876
Practice Address - Country:US
Practice Address - Phone:419-227-3077
Practice Address - Fax:419-224-1667
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.07609363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2456748Medicaid
OHNP14944OtherMEDICARE NUMBER
OH000000351874OtherANTHEM
OHDANP14945Medicare PIN
OHDANP14944Medicare PIN
OH000000351874OtherANTHEM