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General NPI Number Information
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NPI Number | 1164924601
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Entity Type | Individual
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Provider Name | LADONNA SHEREE DOXIE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 125 GOVERNORS SQ
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4871
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Country | US
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Telephone | 678-423-5500
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Fax | 770-400-9313
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Provider Business Mailing Address
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Address Line | PO BOX 2099
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City | DECATUR
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State | GA
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Zip | 30031
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN235664
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License Number State | GA
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