Healthcare Provider Details

I. General information

NPI: 1467729871
Provider Name (Legal Business Name): MARY KATHRYN DOLLARD MSN, CRNP, APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HIGH ST
MONTICELLO NY
12701-1343
US

IV. Provider business mailing address

2 HIGH ST
MONTICELLO NY
12701-1343
US

V. Phone/Fax

Practice location:
  • Phone: 845-791-8800
  • Fax: 845-791-7051
Mailing address:
  • Phone: 845-791-8800
  • Fax: 845-791-7051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00091800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF351170
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP008642
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: