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General NPI Number Information
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NPI Number | 1790454700
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Entity Type | Individual
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Provider Name | KAREN DOLY APRN
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Gender | Female
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | E.COUNTY ROAD 540A
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City | LAKELAND
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State | FL
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Zip | 33813
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Country | US
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Telephone | 863-250-5293
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 185
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City | HIGHLAND CITY
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State | FL
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Zip | 33846-0185
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Country | US
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Telephone | 848-456-0269
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11011841
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License Number State | FL
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