Provider Demographics
NPI:1295056307
Name:WALDROFF, DAWN RENEE (LPN)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:RENEE
Last Name:WALDROFF
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 1:3355 BUELL RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-9211
Mailing Address - Country:US
Mailing Address - Phone:513-738-5652
Mailing Address - Fax:
Practice Address - Street 1:3355 BUELL RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-9211
Practice Address - Country:US
Practice Address - Phone:513-738-5652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN068189164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse