Healthcare Provider Details

I. General information

NPI: 1598116006
Provider Name (Legal Business Name): VIRGINIA DOHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8189 N VERDINO TER
CRYSTAL RIVER FL
34428-6975
US

IV. Provider business mailing address

8189 N VERDINO TER
CRYSTAL RIVER FL
34428-6975
US

V. Phone/Fax

Practice location:
  • Phone: 727-631-7399
  • Fax:
Mailing address:
  • Phone: 727-631-7399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN9224952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: