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General NPI Number Information
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NPI Number | 1528531985
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Entity Type | Individual
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Provider Name | RYANE PLASTER DOTY NP
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Gender | Female
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Dates
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Enumeration Date | 01/09/2019
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 740 AVIGNON DR STE C
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City | RIDGELAND
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State | MS
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Zip | 39157-5160
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Country | US
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Telephone | 601-937-4552
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Fax | 844-374-4872
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Provider Business Mailing Address
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Address Line | 379 WILLIAMS RD
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City | FLORENCE
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State | MS
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Zip | 39073-7954
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Country | US
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Telephone | 601-919-5807
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Fax | 844-374-4872
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 902854
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License Number State | MS
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