Healthcare Provider Details

I. General information

NPI: 1730328931
Provider Name (Legal Business Name): TINA STAFFORD DOGGETT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TINA A THIELS NP

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MEDICAL CENTER DR
ALEXANDRIA LA
71301-8124
US

IV. Provider business mailing address

211 4TH ST BOX 30101
ALEXANDRIA LA
71301-8421
US

V. Phone/Fax

Practice location:
  • Phone: 318-769-7160
  • Fax: 318-769-7473
Mailing address:
  • Phone: 318-769-7160
  • Fax: 318-769-7473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAP04352
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN085762
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP04352
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: