Provider Demographics
NPI:1770255879
Name:DOLLISON, YVE NICHOLE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:YVE
Middle Name:NICHOLE
Last Name:DOLLISON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 E LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GRACEY
Mailing Address - State:KY
Mailing Address - Zip Code:42232-9702
Mailing Address - Country:US
Mailing Address - Phone:360-259-9162
Mailing Address - Fax:
Practice Address - Street 1:320 W 18TH ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1965
Practice Address - Country:US
Practice Address - Phone:270-887-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016627363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner