Provider Demographics
NPI:1700237179
Name:DIBIA, DORIS
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:DIBIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 51ST STREET NE
Mailing Address - Street 2:N/A
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3971
Mailing Address - Country:US
Mailing Address - Phone:202-830-5928
Mailing Address - Fax:
Practice Address - Street 1:1311 DELAWARE AVE SW APT S449
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-3971
Practice Address - Country:US
Practice Address - Phone:202-830-5928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN500002645163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse