Provider Demographics
NPI:1356419535
Name:DOGGETT, ANN M (DC, LPN)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:DOGGETT
Suffix:
Gender:F
Credentials:DC, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BRAINTREE HILL OFFICE PARK STE 101
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-8702
Mailing Address - Country:US
Mailing Address - Phone:617-328-6300
Mailing Address - Fax:617-328-7780
Practice Address - Street 1:15 BRAINTREE HILL OFFICE PARK STE 101
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-8702
Practice Address - Country:US
Practice Address - Phone:617-328-6300
Practice Address - Fax:617-328-7780
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1598111NN1001X, 133NN1002X, 133N00000X
MA1430111NN1001X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1610791Medicaid
MAY3597401Medicare PIN
MAT87730Medicare UPIN