Provider Demographics
NPI:1801856018
Name:DORN, JOANNE (ARNP)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:DORN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21027 LA PENA DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-2935
Mailing Address - Country:US
Mailing Address - Phone:210-788-9123
Mailing Address - Fax:
Practice Address - Street 1:21027 LA PENA DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-2935
Practice Address - Country:US
Practice Address - Phone:512-820-9135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2024-03-21
Deactivation Date:2022-10-17
Deactivation Code:
Reactivation Date:2024-03-20
Provider Licenses
StateLicense IDTaxonomies
TX125208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily