Provider Demographics
NPI:1790503423
Name:DORRITY, KRISTIN NEAL (RN)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NEAL
Last Name:DORRITY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:ELIZABETH
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:484 FIDDLERS GROVE ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-5927
Mailing Address - Country:US
Mailing Address - Phone:432-301-6676
Mailing Address - Fax:
Practice Address - Street 1:484 FIDDLERS GROVE ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-5927
Practice Address - Country:US
Practice Address - Phone:432-301-6676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1646163163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse