Healthcare Provider Details

I. General information

NPI: 1285225029
Provider Name (Legal Business Name): KATINA A DORSEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 03/09/2024
Certification Date: 03/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3343 PEACHTREE RD NE STE 145-1997
ATLANTA GA
30326-1085
US

IV. Provider business mailing address

3343 PEACHTREE RD NE STE 145-1997
ATLANTA GA
30326-1085
US

V. Phone/Fax

Practice location:
  • Phone: 678-539-0038
  • Fax:
Mailing address:
  • Phone: 678-539-0038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN189904
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN189904
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN189904
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: