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NPI Code Detail

MEDICARE: JAMES L DORN CRNA

MEDICARE: JAMES L DORN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistD132293IA

General Provider Information

NPI Number : 1104267863
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES L DORN CRNA
Provider Business Mailing Address
First Line : 419 WHITE FOX DR
Second Line :
City : CLARION
State : IA
Zip : 50525-3200
Country : US
Telephone Number : 205-529-0697
Fax Number :
Provider Business Practice Location Address
First Line : 515 S MOORE ST
Second Line :
City : BLUE EARTH
State : MN
Zip : 56013-2158
Country : US
Telephone Number : 507-526-7919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2013
Last Update Date : 09/19/2020

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