Provider Demographics
NPI:1790921609
Name:DOBKINS, LOUISE C (ANP-BC)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:C
Last Name:DOBKINS
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 PINE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-2846
Mailing Address - Country:US
Mailing Address - Phone:401-454-6625
Mailing Address - Fax:401-454-6628
Practice Address - Street 1:72 PINE ST FL 2
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-2846
Practice Address - Country:US
Practice Address - Phone:401-454-6625
Practice Address - Fax:401-454-6628
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60070033363L00000X
RIAPRN03444363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1790921609Medicaid