Provider Demographics
NPI:1255989158
Name:DOTTS, MISTY LYNN (NP-C)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:LYNN
Last Name:DOTTS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ACADEMY STREET
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-2902
Mailing Address - Country:US
Mailing Address - Phone:828-536-5125
Mailing Address - Fax:828-536-5112
Practice Address - Street 1:14 ACADEMY STREET
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-2902
Practice Address - Country:US
Practice Address - Phone:828-536-5125
Practice Address - Fax:828-536-5112
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012206363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily