Provider Demographics
NPI:1033562756
Name:DODDS, LORENA GAIL (RN)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:GAIL
Last Name:DODDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S CARLISLE ST PO BOX 225
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:OH
Mailing Address - Zip Code:43343
Mailing Address - Country:US
Mailing Address - Phone:937-441-0484
Mailing Address - Fax:937-585-5857
Practice Address - Street 1:104 S CARLISLE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:OH
Practice Address - Zip Code:43343
Practice Address - Country:US
Practice Address - Phone:037-585-5858
Practice Address - Fax:937-585-5857
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.259715163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health