Provider Demographics
NPI:1710288097
Name:MASSEY-KARSZNIA, DORIS LEE (MSN, ANP-BC, RN)
Entity Type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:LEE
Last Name:MASSEY-KARSZNIA
Suffix:
Gender:F
Credentials:MSN, ANP-BC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8306 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3061
Mailing Address - Country:US
Mailing Address - Phone:510-206-0466
Mailing Address - Fax:
Practice Address - Street 1:8306 TERRACE DR
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-3061
Practice Address - Country:US
Practice Address - Phone:510-206-0466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 12243363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health