| Doctor Name: | MARY NICOLE DOLAN |
| NPI Number: | 1184041667 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 47436 |
| Business Practice Address: | 9207 Seneca Trl Ronceverte, WV - 249701328 |
| Business Phone Number: | 3046451787 |
| Business Fax Number: | 3046453630 |
| Mailing Address: | 9207 Seneca Trl, RONCEVERTE |
| State: | WV |
| Postal Code: | 249701328 |
| Phone Number: | 3046451787 |
| Fax Number: | 3046453630 |
| NPI Enumeration Date: | 03/24/2014 |
| NPI Last Update Date: | 03/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA2000X |
| License Number: | 47436 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Administrator |
| Taxonomy Definition: | |