MEDICARE: PATRICIA KAY DOTSON RN

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
1	163WG0000X	General Practice Registered Nurse	RN.0016913	CO

General Provider Information

NPI Number	:	1679207096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA KAY DOTSON RN

Provider Business Mailing Address
First Line	:	111 E 3RD ST STE 221
Second Line	:
City	:	RIFLE
State	:	CO
Zip	:	81650-2346
Country	:	US
Telephone Number	:	970-665-9291
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 E 3RD ST STE 221
Second Line	:
City	:	RIFLE
State	:	CO
Zip	:	81650-2346
Country	:	US
Telephone Number	:	970-665-9291
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	07/12/2022

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