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General NPI Number Information
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NPI Number | 1861817314
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Entity Type | Individual
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Provider Name | MISTY ROSE DOERING APRN
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Gender | Female
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 39 NOTT HWY UNIT 4
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City | ASHFORD
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State | CT
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Zip | 06278-1341
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Country | US
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Telephone | 860-840-1058
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Fax | 860-254-6026
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Provider Business Mailing Address
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Address Line | 39 NOTT HWY UNIT 4
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City | ASHFORD
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State | CT
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Zip | 06278-1341
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Country | US
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Telephone | 860-840-1058
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Fax | 855-803-8591
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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 | 005619
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | 005619
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License Number State | CT
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