Provider Demographics
NPI:1376158600
Name:DORSEY, MARGREK S (NP)
Entity Type:Individual
Prefix:
First Name:MARGREK
Middle Name:S
Last Name:DORSEY
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 1:1305 METRO DR STE 5
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3444
Mailing Address - Country:US
Mailing Address - Phone:318-625-7471
Mailing Address - Fax:833-654-0722
Practice Address - Street 1:1305 METRO DR STE 5
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3444
Practice Address - Country:US
Practice Address - Phone:318-625-7471
Practice Address - Fax:833-654-0722
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP215654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty