Provider Demographics
NPI:1518169127
Name:DOTY, CHRISTINA LYNN (OPTICIAN APPRENTICE)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNN
Last Name:DOTY
Suffix:
Gender:F
Credentials:OPTICIAN APPRENTICE
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:LYNN
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7008 SALINAS CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314
Mailing Address - Country:US
Mailing Address - Phone:910-308-1578
Mailing Address - Fax:910-487-5018
Practice Address - Street 1:1800 N SKIBO RD ST
Practice Address - Street 2:148 A
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303
Practice Address - Country:US
Practice Address - Phone:910-487-1863
Practice Address - Fax:910-487-5018
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAPPRENTICE156FX1800X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Not Answered390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program