Healthcare Provider Details

I. General information

NPI: 1447786769
Provider Name (Legal Business Name): DAWN SERENE AYERS FMHPNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAWN LITHERLAND RN

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 01/17/2025
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 BEL HARBOR DR
LIVERPOOL NY
13090-2621
US

IV. Provider business mailing address

4004 BEL HARBOR DR
LIVERPOOL NY
13090-2621
US

V. Phone/Fax

Practice location:
  • Phone: 315-935-9232
  • Fax:
Mailing address:
  • Phone: 315-935-9232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF405921
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number516271
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: