Healthcare Provider Details

I. General information

NPI: 1487877122
Provider Name (Legal Business Name): DAWN CECIL L.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 STOCKHAM HILL RD
WEST PORTSMOUTH OH
45663-8939
US

IV. Provider business mailing address

5825 STATE ROUTE 141
KITTS HILL OH
45645-8605
US

V. Phone/Fax

Practice location:
  • Phone: 740-585-0458
  • Fax:
Mailing address:
  • Phone: 740-643-0156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN098233
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: