Provider Demographics
NPI:1205597036
Name:DORFLING, CHRISTIN (RN)
Entity type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:
Last Name:DORFLING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHRISTIN
Other - Middle Name:
Other - Last Name:LATHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1485 RED CINDER RD
Mailing Address - Street 2:
Mailing Address - City:CHINO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86323-5463
Mailing Address - Country:US
Mailing Address - Phone:140-531-4620
Mailing Address - Fax:
Practice Address - Street 1:3001 N MAIN ST STE 1B
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-1215
Practice Address - Country:US
Practice Address - Phone:928-445-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ230934363LF0000X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical