Healthcare Provider Details

I. General information

NPI: 1659451185
Provider Name (Legal Business Name): JENNIFER DAWN DAWSON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER DAWN ADROUNI

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 GARDEN WAY STE 102
HERMITAGE PA
16148-5215
US

IV. Provider business mailing address

1034 GROVE ST ATTN: CREDENTIALING
MEADVILLE PA
16335-2945
US

V. Phone/Fax

Practice location:
  • Phone: 724-981-1777
  • Fax: 724-342-2879
Mailing address:
  • Phone: 724-981-1777
  • Fax: 724-342-2879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number46200
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS025618
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTL-2112
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A10749
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number46200
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: