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General NPI Number Information
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NPI Number | 1861089039
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Entity Type | Individual
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Provider Name | SHENANDOAH PUTNEY DOLE AGPCNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/22/2020
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 81 S MAIN ST
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City | WARSAW
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State | NY
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Zip | 14569-1571
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Country | US
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Telephone | 585-228-1195
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Fax | 585-185-2067
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Provider Business Mailing Address
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Address Line | 4247 SILVER SPRINGS RD
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City | SILVER SPRINGS
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State | NY
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Zip | 14550-9702
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Country | US
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Telephone | 585-519-2859
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F310068
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License Number State | NY
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