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General NPI Number Information
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NPI Number | 1336601210
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Entity Type | Individual
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Provider Name | KATHERINE JOY DORMAN APRN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 11202 W JOBLANCA RD
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City | AVONDALE
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State | AZ
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Zip | 85323
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Country | US
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Telephone | 623-920-2720
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Fax | 623-777-6004
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Provider Business Mailing Address
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Address Line | 4244 W VERNON AVE
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City | PHOENIX
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State | AZ
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Zip | 85009-1010
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Country | US
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Telephone | 915-351-6600
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Fax | 623-777-6004
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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 | AP141021
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License Number State | TX
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