Healthcare Provider Details

I. General information

NPI: 1376588319
Provider Name (Legal Business Name): LOUISE DAPOZ MSN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 WALES AVE NW
MASSILLON OH
44646-2393
US

IV. Provider business mailing address

2051 WALES AVE NW
MASSILLON OH
44646-2393
US

V. Phone/Fax

Practice location:
  • Phone: 330-363-7462
  • Fax:
Mailing address:
  • Phone: 330-363-7462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP08807
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: