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NPI Code Detail

MEDICARE: DAWN SOVA

MEDICARE: DAWN SOVA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse407676OH

General Provider Information

NPI Number : 1104221696
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN SOVA
Provider Business Mailing Address
First Line : 5663 REVERE DR
Second Line :
City : NORTH OLMSTED
State : OH
Zip : 44070-4473
Country : US
Telephone Number : 440-915-8416
Fax Number :
Provider Business Practice Location Address
First Line : 5663 REVERE DR
Second Line :
City : NORTH OLMSTED
State : OH
Zip : 44070-4473
Country : US
Telephone Number : 440-915-8416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2014
Last Update Date : 10/27/2014

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Directions to “ DAWN SOVA ” Practice Location

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