Healthcare Provider Details

I. General information

NPI: 1154670149
Provider Name (Legal Business Name): DAWN L PAULSEN F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 W GENESEE ST
SYRACUSE NY
13204-2243
US

IV. Provider business mailing address

1050 W GENESEE ST
SYRACUSE NY
13204-2243
US

V. Phone/Fax

Practice location:
  • Phone: 315-641-2385
  • Fax: 315-305-4677
Mailing address:
  • Phone: 315-447-4663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF337425-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: