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NPI Code Detail

MEDICARE: MRS. STELLA DELORES DOLGNER A.R.N.P.

MEDICARE: MRS. STELLA DELORES DOLGNER A.R.N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse PractitionerAP30000641WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18931002OTHERWACRIME VICTIM COMPENSATION
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30176650OTHERWAWORKERS COMPENSATION

General Provider Information

NPI Number : 1255381836
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STELLA DELORES DOLGNER A.R.N.P.
Provider Business Mailing Address
First Line : PO BOX 3188
Second Line :
City : OMAK
State : WA
Zip : 98841-3188
Country : US
Telephone Number : 509-826-1600
Fax Number : 509-826-3633
Provider Business Practice Location Address
First Line : 529 JASMINE ST
Second Line :
City : OMAK
State : WA
Zip : 98841-9589
Country : US
Telephone Number : 509-826-1600
Fax Number : 509-826-3633
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 12/05/2012

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