Healthcare Provider Details

I. General information

NPI: 1316015696
Provider Name (Legal Business Name): CATHERINE LYNN DOTY APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2006
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 N JAMES ST SUITES 100D
NEWPORT DE
19804-3169
US

IV. Provider business mailing address

112 INTERLACHEN CT
AVONDALE PA
19311-9747
US

V. Phone/Fax

Practice location:
  • Phone: 484-574-0222
  • Fax:
Mailing address:
  • Phone: 484-574-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberLE 0000170
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberLE-0000170
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberLE-0000170
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: