MEDICARE: BRIAN PATRICK DOLAN RN,BSN, RNFA, CNOR

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	163WR0006X	Registered Nurse First Assistant	RN638705	PA

General Provider Information

NPI Number	:	1477402543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN PATRICK DOLAN RN,BSN, RNFA, CNOR

Provider Business Mailing Address
First Line	:	315 KENT RD
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-3301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 FARM RD
Second Line	:
City	:	WAYNE
State	:	PA
Zip	:	19087-3303
Country	:	US
Telephone Number	:	309-531-0220
Fax Number	:

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

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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