Provider Demographics
NPI:1821023847
Name:DOLAN, JUDITH CAROLE (CRNA)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:CAROLE
Last Name:DOLAN
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:PO BOX 966
Mailing Address - Street 2:SUTTER CREEK OB ANESTHESIA SVS
Mailing Address - City:SUTTER CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:95685-0966
Mailing Address - Country:US
Mailing Address - Phone:888-270-0340
Mailing Address - Fax:888-270-0331
Practice Address - Street 1:7500 TIMBERLAKE WAY
Practice Address - Street 2:METHODIST HOSPITAL
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5417
Practice Address - Country:US
Practice Address - Phone:916-423-3000
Practice Address - Fax:888-270-0331
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN529382163W00000X
CANA3081367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANA3081OtherSTATE LICENSE
CARN529382OtherSTATE LICENSE