Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | A116011 | IA |
NPI | 1003313750 |
---|---|
Provider Name | Rachael M. Doty |
First Address | Des Moines, IA 50305-1475 |
Second Address | Des Moines, IA 50314-3027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2018 |
Last Update Date | 11/11/2020 |