Provider Demographics
NPI:1417234204
Name:DORCHESTER COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:DORCHESTER COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:LANISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHN
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:410-228-3223
Mailing Address - Street 1:3 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2362
Mailing Address - Country:US
Mailing Address - Phone:410-228-3223
Mailing Address - Fax:410-228-9319
Practice Address - Street 1:3 CEDAR ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2362
Practice Address - Country:US
Practice Address - Phone:410-228-3223
Practice Address - Fax:410-228-9319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2015-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty