Provider Demographics
NPI:1992206205
Name:DOLAN, NATALIE M (PA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:DOLAN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:3170 KETTERING BLVD BLDG B3
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1924
Mailing Address - Country:US
Mailing Address - Phone:937-991-3188
Mailing Address - Fax:937-223-9811
Practice Address - Street 1:900 UNION ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-5408
Practice Address - Country:US
Practice Address - Phone:508-366-8836
Practice Address - Fax:508-616-4411
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2020-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAPA6441363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant