Provider Demographics
NPI:1609496033
Name:DOSSETT, ANGELA (MSN, PMHNP-BS ARNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:DOSSETT
Suffix:
Gender:F
Credentials:MSN, PMHNP-BS ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W BURLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-3242
Mailing Address - Country:US
Mailing Address - Phone:641-472-5771
Mailing Address - Fax:641-472-1817
Practice Address - Street 1:301 W BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556-3242
Practice Address - Country:US
Practice Address - Phone:641-472-5771
Practice Address - Fax:641-472-1817
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG158384363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health