Provider Demographics
NPI:1972855427
Name:KLYPCHAK, DAWN NOELLE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:DAWN
Middle Name:NOELLE
Last Name:KLYPCHAK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3574 WARREN RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3039
Mailing Address - Country:US
Mailing Address - Phone:216-235-2279
Mailing Address - Fax:
Practice Address - Street 1:3574 WARREN RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3039
Practice Address - Country:US
Practice Address - Phone:216-235-2279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2015-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH145488164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse