Provider Demographics
NPI:1851151575
Name:DORAN, EMILIE ROSE (BSN, MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:EMILIE
Middle Name:ROSE
Last Name:DORAN
Suffix:
Gender:F
Credentials:BSN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 541
Mailing Address - Street 2:
Mailing Address - City:PINE ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10969-0541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2745 ROUTE 6
Practice Address - Street 2:
Practice Address - City:SLATE HILL
Practice Address - State:NY
Practice Address - Zip Code:10973-4119
Practice Address - Country:US
Practice Address - Phone:845-772-2973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF353128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily