Healthcare Provider Details

I. General information

NPI: 1982536124
Provider Name (Legal Business Name): BRITTANY NICOLE DORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2349 RUSSELLVILLE RD
BOWLING GREEN KY
42101-3986
US

IV. Provider business mailing address

229 LINDSAY LN
RUSSELLVILLE KY
42276-9620
US

V. Phone/Fax

Practice location:
  • Phone: 270-893-8465
  • Fax:
Mailing address:
  • Phone: 270-893-8465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number254890
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: