Provider Demographics
NPI:1285888693
Name:DOONER, KATHLEEN SARAH (CNP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:SARAH
Last Name:DOONER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 931219
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-1461
Mailing Address - Country:US
Mailing Address - Phone:800-270-2955
Mailing Address - Fax:
Practice Address - Street 1:24400 CHAGRIN BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5642
Practice Address - Country:US
Practice Address - Phone:216-765-0358
Practice Address - Fax:216-765-0378
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-04590363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health