Individual
ELISABETH ANNE DOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 445-2579
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA.12837-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0061718
—
OH
01
—
PO1063585
RAILROAD MEDICARE
OH
Enumeration date
11/06/2011
Last updated
09/26/2013
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