Basic Information
| Provider Information | |||||||||
| NPI: | 1821659764 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALDRICH | ||||||||
| FirstName: | DAWN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16764 COUNTY ROAD U | ||||||||
| Address2: | |||||||||
| City: | NAPOLEON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435459753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195916404 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6819 SPRING VALLEY DR | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435289487 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199305700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2019 | ||||||||
| LastUpdateDate: | 06/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | CNP024872 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.