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General NPI Number Information
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NPI Number | 1043314271
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Entity Type | Individual
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Provider Name | DOROTHY JOY DUTTON FNP, CNM
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Gender | Female
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 94125 4TH STREET
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City | GOLD BEACH
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State | OR
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Zip | 97444
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Country | US
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Telephone | 541-247-6628
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Fax | 541-247-6629
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Provider Business Mailing Address
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Address Line | PO BOX 1215 94125 4TH STREET
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City | GOLD BEACH
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State | OR
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Zip | 97444-1215
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Country | US
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Telephone | 541-247-6628
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Fax | 541-247-6629
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200650112NP FNP-PP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 200150025NP NMNP-PP
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License Number State | OR
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