Provider Demographics
NPI:1639456320
Name:DORST, N HEATHER (RN, MAC, LAC)
Entity Type:Individual
Prefix:MS
First Name:N
Middle Name:HEATHER
Last Name:DORST
Suffix:
Gender:F
Credentials:RN, MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 YELLOWWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4622
Mailing Address - Country:US
Mailing Address - Phone:410-367-0606
Mailing Address - Fax:410-367-1961
Practice Address - Street 1:4801 YELLOWWOOD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4622
Practice Address - Country:US
Practice Address - Phone:410-367-0606
Practice Address - Fax:410-367-1961
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00315171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist