Provider Demographics
NPI:1710632021
Name:DORSEY, LAQUISHA CHERELL (FNP)
Entity Type:Individual
Prefix:
First Name:LAQUISHA
Middle Name:CHERELL
Last Name:DORSEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8353 LEE HALL AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3446
Mailing Address - Country:US
Mailing Address - Phone:757-218-1372
Mailing Address - Fax:
Practice Address - Street 1:2929 LONDON BLVD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3405
Practice Address - Country:US
Practice Address - Phone:757-861-9010
Practice Address - Fax:757-861-9011
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAF12210829207Q00000X
VA0024183917363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine