Healthcare Provider Details

I. General information

NPI: 1043680325
Provider Name (Legal Business Name): GHANA DORSEY PMHNP-BC, FNP-BC FPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6514 MEADOWRIDGE RD
ELKRIDGE MD
21075-6115
US

IV. Provider business mailing address

2516 SILVER ROCK DR
CREST HILL IL
60403-8906
US

V. Phone/Fax

Practice location:
  • Phone: 410-387-3881
  • Fax:
Mailing address:
  • Phone: 314-458-5064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277002496
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: