Provider Demographics
NPI:1699377556
Name:DAILEY, DAWN W
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:W
Last Name:DAILEY
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 1:2410 NORTON RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1647
Mailing Address - Country:US
Mailing Address - Phone:330-571-0721
Mailing Address - Fax:
Practice Address - Street 1:1127 JESSIE AVE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-3311
Practice Address - Country:US
Practice Address - Phone:330-571-0721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide