Provider Demographics
NPI:1972702629
Name:DOLAN, JANICE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:
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 1:721 PEACH TREE DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-6494
Mailing Address - Country:US
Mailing Address - Phone:610-220-7316
Mailing Address - Fax:
Practice Address - Street 1:1 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1601
Practice Address - Country:US
Practice Address - Phone:610-408-0822
Practice Address - Fax:610-408-9187
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA042474367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered