Healthcare Provider Details

I. General information

NPI: 1568500361
Provider Name (Legal Business Name): DAWN M. BONELLA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAWN M. ROWELL CRNP

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 10/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W LANCASTER AVE
PAOLI PA
19301-1763
US

IV. Provider business mailing address

255 W LANCASTER AVE
PAOLI PA
19301-1763
US

V. Phone/Fax

Practice location:
  • Phone: 484-565-1600
  • Fax: 610-647-2006
Mailing address:
  • Phone: 484-565-1600
  • Fax: 610-647-2006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP009317
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: