Healthcare Provider Details

I. General information

NPI: 1093465874
Provider Name (Legal Business Name): JAMEKA DORSEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 10/27/2023
Certification Date: 10/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 PEACHTREE ST NE STE 1000
ATLANTA GA
30361-3542
US

IV. Provider business mailing address

1175 PEACHTREE ST NE STE 100
ATLANTA GA
30361-3529
US

V. Phone/Fax

Practice location:
  • Phone: 412-403-2156
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN254748
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN254748
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberRN254748
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberRN254748
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: