Provider Demographics
NPI:1720619778
Name:DOLL, ANNE-MARIE COUTU (PA-C)
Entity Type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:COUTU
Last Name:DOLL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANNE-MARIE
Other - Middle Name:CHRISTINA
Other - Last Name:COUTU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5935 ADELYN RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-7738
Mailing Address - Country:US
Mailing Address - Phone:850-293-6491
Mailing Address - Fax:
Practice Address - Street 1:4541 N DAVIS HWY STE A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2733
Practice Address - Country:US
Practice Address - Phone:850-494-9000
Practice Address - Fax:850-416-1248
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9112951363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant