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NPI Code Detail

MEDICARE: MS. DORI LYNN DEFFIT APRN CNP

MEDICARE: MS. DORI LYNN DEFFIT APRN CNP
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
1363LF0000XFamily Nurse Practitioner105307OK

General Provider Information

NPI Number : 1326510488
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DORI LYNN DEFFIT APRN CNP
Provider Business Mailing Address
First Line : 1100 N COLLEGE AVE
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-1944
Country : US
Telephone Number : 417-891-4800
Fax Number : 417-891-4912
Provider Business Practice Location Address
First Line : 1100 N COLLEGE AVE
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-1944
Country : US
Telephone Number : 417-891-4800
Fax Number : 417-891-4912
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2018
Last Update Date : 03/06/2026

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