Doctor Name: | JENNIFER RENHAE DORSEY |
NPI Number: | 1972939122 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 93355 |
Business Practice Address: | 1104 E Central Blvd Suite F100 Anadarko, OK - 730054406 |
Business Phone Number: | 4052476685 |
Business Fax Number: | 4052472043 |
Mailing Address: | 1145 W I 240 Service Rd Ste F100, OKLAHOMA CITY |
State: | OK |
Postal Code: | 731392134 |
Phone Number: | 4056056141 |
Fax Number: | 4056056244 |
NPI Enumeration Date: | 09/19/2013 |
NPI Last Update Date: | 02/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 93355 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |