Healthcare Provider Details

I. General information

NPI: 1205230356
Provider Name (Legal Business Name): AMY DORON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10506 MONTGOMERY RD STE 402
CINCINNATI OH
45242-4489
US

IV. Provider business mailing address

7835 PARAGON RD
DAYTON OH
45459-4021
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-6161
  • Fax: 513-791-4004
Mailing address:
  • Phone: 937-436-4148
  • Fax: 937-434-1266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3010119
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number382482
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA. 17479-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: