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General NPI Number Information
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NPI Number | 1255974093
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Entity Type | Individual
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Provider Name | JAIME DOTY RM, CPM
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Gender | Female
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 140 PALOMINO TRL
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City | RIDGWAY
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State | CO
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Zip | 81432-9252
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Country | US
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Telephone | 308-636-6184
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 562
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City | RIDGWAY
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State | CO
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Zip | 81432-0562
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | MWR.0000190
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License Number State | CO
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