Provider Demographics
NPI:1225705528
Name:DORSETT, MATTHEW (FNP-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:DORSETT
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27572 COUNTY ROAD 66 N
Mailing Address - Street 2:
Mailing Address - City:LOXLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36551-4011
Mailing Address - Country:US
Mailing Address - Phone:251-234-9209
Mailing Address - Fax:
Practice Address - Street 1:27572 COUNTY ROAD 66 N
Practice Address - Street 2:
Practice Address - City:LOXLEY
Practice Address - State:AL
Practice Address - Zip Code:36551-4011
Practice Address - Country:US
Practice Address - Phone:251-234-9209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-162606363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily