Provider Demographics
NPI:1922157247
Name:DOTSON, DARLENE L (CFNP)
Entity Type:Individual
Prefix:MISS
First Name:DARLENE
Middle Name:L
Last Name:DOTSON
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1454 DEVON MILL WAY
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168
Mailing Address - Country:US
Mailing Address - Phone:770-739-6175
Mailing Address - Fax:770-422-2814
Practice Address - Street 1:140 LACY STREET
Practice Address - Street 2:SUITE A
Practice Address - City:MAREITTA
Practice Address - State:GA
Practice Address - Zip Code:30060
Practice Address - Country:US
Practice Address - Phone:770-422-1985
Practice Address - Fax:770-422-2814
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN088140363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner