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General NPI Number Information
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NPI Number | 1922661800
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Entity Type | Organization
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Legal Business Name | DORCUS HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 105 GREYSTONE DR
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City | GUYTON
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State | GA
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Zip | 31312-5548
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Country | US
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Telephone | 757-842-3824
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Fax |
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Provider Business Mailing Address
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Address Line | 105 GREYSTONE DR
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City | GUYTON
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State | GA
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Zip | 31312-5548
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Country | US
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Telephone | 757-842-3824
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Fax |
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Authorized Official
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Title or Position | NURSE PRATITIONER
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Name | LATOSHA D TRIPLET
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Credential | AGNP-C
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Telephone | 757-842-3824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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