Provider Demographics
NPI:1346205796
Name:DIGHTON, DOROTHY L (FNP)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:L
Last Name:DIGHTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:L
Other - Last Name:JUNGERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:MISSOURI ST & HWY 24
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:MO
Mailing Address - Zip Code:64096
Mailing Address - Country:US
Mailing Address - Phone:660-493-2262
Mailing Address - Fax:660-493-2796
Practice Address - Street 1:MISSOURI ST & HWY 24
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:MO
Practice Address - Zip Code:64096
Practice Address - Country:US
Practice Address - Phone:660-493-2262
Practice Address - Fax:660-493-2796
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO043689363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
30364101OtherBCBS
P27B157Medicare ID - Type Unspecified
S77165Medicare UPIN