Provider Demographics
NPI:1629676754
Name:TONI DORSETT FNP-C, PLLC
Entity Type:Organization
Organization Name:TONI DORSETT FNP-C, PLLC
Other - Org Name:BOAZ COMPLETE FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:DORSETT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:817-480-9296
Mailing Address - Street 1:PO BOX 164901
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76161-4901
Mailing Address - Country:US
Mailing Address - Phone:817-480-9296
Mailing Address - Fax:
Practice Address - Street 1:200 WJ BOAZ RD STE 200
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76179-1291
Practice Address - Country:US
Practice Address - Phone:817-480-9296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty