Provider Demographics
NPI:1356080261
Name:DOTTOLO, CHRISTIN ANN (RN, BSN)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:ANN
Last Name:DOTTOLO
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10343 SIEGEN LN STE 3B
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-4981
Mailing Address - Country:US
Mailing Address - Phone:225-205-8185
Mailing Address - Fax:
Practice Address - Street 1:10343 SIEGEN LN STE 3B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-4981
Practice Address - Country:US
Practice Address - Phone:225-205-8185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN110134163W00000X
246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other