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NPI 1124122122

NPI 1124122122 : DOROTHY L. DUERFELDT PA-C : VALENTINE, NE

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General NPI Number Information
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    NPI Number           |    1124122122
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    Entity Type          |    Individual 
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    Provider Name        |    DOROTHY L. DUERFELDT PA-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/11/2006
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    Last Update Date     |    01/07/2008
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Provider Practice Location Address
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    Address Line         |    512 NORTH GREEN ST 
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    City                 |    VALENTINE
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    State                |    NE
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    Zip                  |    69201-1982
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    Country              |    US
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    Telephone            |    402-376-3770
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    Fax                  |    402-376-3779
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Provider Business Mailing Address
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    Address Line         |    PO BOX 410 
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    City                 |    VALENTINE
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    State                |    NE
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    Zip                  |    69201-0410
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    Country              |    US
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    Telephone            |    402-376-2525
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    Fax                  |    402-376-1627
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    1172
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    License Number State |    NE
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