Provider Demographics
NPI:1609184761
Name:ETCHELL, DAWN RENE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:RENE
Last Name:ETCHELL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17325 EUCLID AVE # CL42
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1209
Mailing Address - Country:US
Mailing Address - Phone:216-738-4946
Mailing Address - Fax:216-738-4138
Practice Address - Street 1:17325 EUCLID AVE # CL42
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1209
Practice Address - Country:US
Practice Address - Phone:216-738-4946
Practice Address - Fax:216-738-4138
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH285298367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered