Provider Demographics
NPI:1952519027
Name:JAMES, NICOLE ADELLE DORFLING (PA-C)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:ADELLE DORFLING
Last Name:JAMES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 WESTPARK DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3174
Mailing Address - Country:US
Mailing Address - Phone:678-263-3080
Mailing Address - Fax:678-496-9863
Practice Address - Street 1:105 WESTPARK DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3174
Practice Address - Country:US
Practice Address - Phone:678-263-3080
Practice Address - Fax:678-496-9863
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA53612084P0804X
GA005361363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry