Provider Demographics
NPI:1063847846
Name:MONROE, DOROTHY S (NP)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:S
Last Name:MONROE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SUMMITT ST
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TN
Mailing Address - Zip Code:37874-2534
Mailing Address - Country:US
Mailing Address - Phone:423-351-7000
Mailing Address - Fax:423-351-7405
Practice Address - Street 1:205 SUMMITT ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TN
Practice Address - Zip Code:37874-2534
Practice Address - Country:US
Practice Address - Phone:423-351-7000
Practice Address - Fax:423-351-7405
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000017663363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner