Provider Demographics
NPI:1437412863
Name:DOBSON, CHANNEL DION (MSN, FNP, RN)
Entity Type:Individual
Prefix:MS
First Name:CHANNEL
Middle Name:DION
Last Name:DOBSON
Suffix:
Gender:F
Credentials:MSN, FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 CORTLAND CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-4011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1046 E WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6712
Practice Address - Country:US
Practice Address - Phone:336-272-1050
Practice Address - Fax:336-272-1110
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC246894163W00000X
NCDOBS-K28E61363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse