Provider Demographics
NPI:1861647802
Name:DOTSON, DONNA WEEDEN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:WEEDEN
Last Name:DOTSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:FAYE
Other - Last Name:WEEDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:451 FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70801-1700
Mailing Address - Country:US
Mailing Address - Phone:225-388-7847
Mailing Address - Fax:225-388-7605
Practice Address - Street 1:451 FLORIDA ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70801-1700
Practice Address - Country:US
Practice Address - Phone:225-388-7847
Practice Address - Fax:225-388-7605
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN055471163WX0106X
LAAPO4295363LF0000X
TX810318363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health