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General NPI Number Information
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NPI Number | 1013373471
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Entity Type | Individual
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Provider Name | CAROLYN JANE DODSON NP
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Gender | Female
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Dates
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Enumeration Date | 01/14/2016
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 28303 DEQUINDRE RD STE 100
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-3040
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Country | US
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Telephone | 248-658-1116
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Fax |
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Provider Business Mailing Address
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Address Line | 50072 LUDWIG CT
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48317-6346
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704273522
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License Number State | MI
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