Provider Demographics
NPI:1427239680
Name:DAWE, KRISTY IRENE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:IRENE
Last Name:DAWE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:WEISSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:18235-2213
Mailing Address - Country:US
Mailing Address - Phone:610-379-9304
Mailing Address - Fax:610-379-9308
Practice Address - Street 1:413 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:WEISSPORT
Practice Address - State:PA
Practice Address - Zip Code:18235-2213
Practice Address - Country:US
Practice Address - Phone:610-379-9304
Practice Address - Fax:610-379-9308
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily