MEDICARE: TINA STAFFORD DOGGETT NP

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	363L00000X	Nurse Practitioner	AP04352	LA
2	363LN0000X	Neonatal Nurse Practitioner	AP04352	LA
3	163W00000X	Registered Nurse	RN085762	LA

General Provider Information

NPI Number	:	1730328931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA STAFFORD DOGGETT NP

Provider Business Mailing Address
First Line	:	6006 SETTLERS DR
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-6008
Country	:	US
Telephone Number	:	318-308-0628
Fax Number	:

Provider Business Practice Location Address
First Line	:	6006 SETTLERS DR
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-6008
Country	:	US
Telephone Number	:	318-308-0628
Fax Number	:

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

Provider Enumeration Date	:	02/11/2009
Last Update Date	:	02/10/2026

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