Provider Demographics
NPI:1396518577
Name:DORSEY, KATHERINE MARGARET (RN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARGARET
Last Name:DORSEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARGARET
Other - Last Name:DUBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:409 N HARBOR LIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-5005
Mailing Address - Country:US
Mailing Address - Phone:904-415-0203
Mailing Address - Fax:
Practice Address - Street 1:409 N HARBOR LIGHTS DR
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-5005
Practice Address - Country:US
Practice Address - Phone:904-415-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9304014163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse