=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255078952
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAWN MICHELE ELDRED DNP, AGPCNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2022
-----------------------------------------------------
Last Update Date | 12/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 FAIRFIELD DR
-----------------------------------------------------
City | SENECA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16346-2130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-676-7900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 120 UNION ST
-----------------------------------------------------
City | TITUSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16354-1158
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-676-7900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | SP025662
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------