Healthcare Provider Details

I. General information

NPI: 1730569922
Provider Name (Legal Business Name): MEG DORSEY RN PHN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2015
Last Update Date: 06/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11484 B AVE
AUBURN CA
95603-2603
US

IV. Provider business mailing address

5229 WESTRIDGE AVE
AUBURN CA
95602-8801
US

V. Phone/Fax

Practice location:
  • Phone: 530-889-7160
  • Fax:
Mailing address:
  • Phone: 530-878-6125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number312657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: