Healthcare Provider Details

I. General information

NPI: 1376972679
Provider Name (Legal Business Name): KRISTIN DOROTICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9816 MAYLAND DR
RICHMOND VA
23233-1457
US

IV. Provider business mailing address

9816 MAYLAND DR
RICHMOND VA
23233-1457
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-8510
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9246823
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: