Basic Information
| Provider Information | |||||||||
| NPI: | 1831131283 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRONG | ||||||||
| FirstName: | DAWN | ||||||||
| MiddleName: | DILWORTH | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DILWORTH | ||||||||
| OtherFirstName: | DAWN | ||||||||
| OtherMiddleName: | M | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CRNA | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 713749 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452713749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144132233 | ||||||||
| FaxNumber: | 6144132234 | ||||||||
| Practice Location | |||||||||
| Address1: | 6520 W CAMPUS OVAL | ||||||||
| Address2: | |||||||||
| City: | NEW ALBANY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430548726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144132233 | ||||||||
| FaxNumber: | 6144132234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2006 | ||||||||
| LastUpdateDate: | 05/11/2015 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN294209 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | COA.08528-NA | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 2635152 | 05 | OH | MEDICAID | 104820121 | 01 | MI | MICHIGAN MEDICAID | OTHER |