MEDICARE: DAWN DAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WW0000X	Wound Care Registered Nurse	194448	OH
2	163W00000X	Registered Nurse	194448	OH
3	163WG0000X	General Practice Registered Nurse	194448	OH
4	163WG0600X	Gerontology Registered Nurse	194448	OH
5	163WR0400X	Rehabilitation Registered Nurse	194448	OH

General Provider Information

NPI Number	:	1336809839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN DAY

Provider Business Mailing Address
First Line	:	1333 CLEVELAND AVE NW APT 3
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44703-3145
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1333 CLEVELAND AVE NW APT 3
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44703-3145
Country	:	US
Telephone Number	:	330-806-7091
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2021
Last Update Date	:	12/23/2021

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Directions to “ DAWN DAY ” Practice Location

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