Provider Demographics
NPI:1023204765
Name:PIOSZAK, DOROTHY SUSAN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:SUSAN
Last Name:PIOSZAK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16341 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:MI
Mailing Address - Zip Code:49777-8652
Mailing Address - Country:US
Mailing Address - Phone:810-513-4126
Mailing Address - Fax:
Practice Address - Street 1:4900 M 32 W
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1499
Practice Address - Country:US
Practice Address - Phone:989-354-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704172619363LA2200X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health