Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD46007 | TN |
Y | 2080P0201X | Pediatric Allergist | MD46007 | TN |
NPI | 1275737751 |
---|---|
Provider Name | Dr. Stacy Dorris |
First Address | Nashville, TN 37204-3609 |
Second Address | Nashville, TN 37204-3609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 15/10/2020 |