Provider Demographics
NPI:1891412748
Name:DOTY, LAURIE ANN
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:DOTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7125 S CARR RD
Mailing Address - Street 2:
Mailing Address - City:APPLE CREEK
Mailing Address - State:OH
Mailing Address - Zip Code:44606-9767
Mailing Address - Country:US
Mailing Address - Phone:330-464-4090
Mailing Address - Fax:330-698-1803
Practice Address - Street 1:7125 S CARR RD
Practice Address - Street 2:
Practice Address - City:APPLE CREEK
Practice Address - State:OH
Practice Address - Zip Code:44606-9767
Practice Address - Country:US
Practice Address - Phone:330-464-4090
Practice Address - Fax:330-698-1803
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide