Provider Demographics
NPI:1740550680
Name:STRONG, DAWN ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ROSE
Last Name:STRONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 VIEWMONT DR
Mailing Address - Street 2:
Mailing Address - City:DICKSON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18519-1664
Mailing Address - Country:US
Mailing Address - Phone:570-346-1464
Mailing Address - Fax:570-346-7450
Practice Address - Street 1:920 VIEWMONT DR
Practice Address - Street 2:
Practice Address - City:DICKSON CITY
Practice Address - State:PA
Practice Address - Zip Code:18519-1664
Practice Address - Country:US
Practice Address - Phone:570-346-1464
Practice Address - Fax:570-346-7450
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002850L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical