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General NPI Number Information
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NPI Number | 1902866148
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Entity Type | Individual
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Provider Name | KATHY A DALZELL C.N.P.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 5319 HOAG DR STE 100
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City | SHEFFIELD VILLAGE
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State | OH
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Zip | 44035-1492
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Country | US
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Telephone | 440-930-6040
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Fax | 440-930-6094
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Provider Business Mailing Address
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Address Line | 5319 HOAG DR STE 100
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City | SHEFFIELD VILLAGE
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State | OH
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Zip | 44035-1492
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Country | US
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Telephone | 440-324-0092
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Fax | 440-324-0093
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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 | NP06612
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License Number State | OH
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