Provider Demographics
NPI:1689255341
Name:DOTTEN, ELAINE (LPN)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:
Last Name:DOTTEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 SW 53RD LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-3981
Mailing Address - Country:US
Mailing Address - Phone:352-672-3924
Mailing Address - Fax:352-548-1139
Practice Address - Street 1:2660 SW 53RD LN
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-3981
Practice Address - Country:US
Practice Address - Phone:352-672-3924
Practice Address - Fax:352-548-1139
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5179422164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse