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NPI 1568792893

NPI 1568792893 : STEPHANIE L DORSEY M.S.N. : JACKSONVILLE, FL

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General NPI Number Information
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    NPI Number           |    1568792893
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    Entity Type          |    Individual 
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    Provider Name        |    STEPHANIE L DORSEY M.S.N.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/08/2010
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    Last Update Date     |    07/16/2014
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Provider Practice Location Address
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    Address Line         |    4280 SOUTHSIDE BLVD 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32216-5400
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    Country              |    US
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    Telephone            |    904-998-3677
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4280 SOUTHSIDE BLVD 
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    City                 |    JACKSONVILLE
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    State                |    FL
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    Zip                  |    32216-5400
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    Country              |    US
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    Telephone            |    615-775-4876
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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       |    14321
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    License Number State |    TN
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Taxonomy #2
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    9348138
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    License Number State |    FL
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