Provider Demographics
NPI:1043505779
Name:VRSEK, DORIS MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:DORIS
Middle Name:MARIE
Last Name:VRSEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:DORIS
Other - Middle Name:MARIE
Other - Last Name:MCEACHERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2830 CORUNNA RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-3254
Mailing Address - Country:US
Mailing Address - Phone:810-235-6812
Mailing Address - Fax:810-234-7022
Practice Address - Street 1:2830 CORUNNA RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-3254
Practice Address - Country:US
Practice Address - Phone:810-235-6812
Practice Address - Fax:810-234-7022
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704280843163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse