Provider Demographics
NPI:1942965041
Name:DORAN, NICOLE (ARNP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:DORAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 W 7TH AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2321
Mailing Address - Country:US
Mailing Address - Phone:509-455-8820
Mailing Address - Fax:
Practice Address - Street 1:62 W 7TH AVE STE 232&450
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2321
Practice Address - Country:US
Practice Address - Phone:509-455-8820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00174265163W00000X
WAAP61247487363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse