Provider Demographics
NPI:1588852156
Name:DORMAN, ESTHER ANNIECE (FNP)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:ANNIECE
Last Name:DORMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 N BRYAN ST
Mailing Address - Street 2:
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79007-4010
Mailing Address - Country:US
Mailing Address - Phone:806-274-2986
Mailing Address - Fax:806-274-9176
Practice Address - Street 1:104 N BRYAN ST
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-4010
Practice Address - Country:US
Practice Address - Phone:806-274-2986
Practice Address - Fax:806-274-9176
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX543784363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily