Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 71000344A | IN |
NPI | 1003866625 |
---|---|
Provider Name | Mrs. Karen Mary Dorsett |
First Address | Indianapolis, IN 46278-1381 |
Second Address | Indianapolis, IN 46278-1381 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 03/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200230940 | (05) | IN |
S57286 | (02) | IN |