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General NPI Number Information
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NPI Number | 1790107407
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Entity Type | Individual
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Provider Name | TINA MARIE DORNER RN
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Gender | Female
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Dates
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Enumeration Date | 01/15/2014
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Last Update Date | 01/15/2014
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Provider Practice Location Address
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Address Line | CMR 415 BOX 3436
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City | APO
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State | AE
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Zip | 09114-0035
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Country | US
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Telephone | 499641836584
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Fax |
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Provider Business Mailing Address
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Address Line | USA MEDDAC BAVARIA CMR 411, BLDG 700, ROSE BARRACKS
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City | APO
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State | AE
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Zip | 09114
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Country | US
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Telephone | 499662834719
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Fax | 499662834721
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | RN150467
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License Number State | GA
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