Provider Demographics
NPI:1982680864
Name:DOLAN, JANICE (MSN/FNP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:DOLAN
Suffix:
Gender:F
Credentials:MSN/FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 STRATTON CIR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2273
Mailing Address - Country:US
Mailing Address - Phone:925-708-7595
Mailing Address - Fax:925-938-9709
Practice Address - Street 1:1881 STRATTON CIR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2273
Practice Address - Country:US
Practice Address - Phone:925-708-7595
Practice Address - Fax:925-938-9709
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN439404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ25345ZMedicare ID - Type Unspecified