Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 305390 | NY |
NPI | 1003136300 |
---|---|
Provider Name | Karen D Doll |
First Address | Charleston, SC 29424-0001 |
Second Address | Charleston, SC 29424-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2010 |
Last Update Date | 13/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03743675 | (05) | NY |