Provider Demographics
NPI:1871013441
Name:CASH, DOROTHY DIANNE (NP)
Entity type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:DIANNE
Last Name:CASH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 ROCK HILL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:COTTONDALE
Mailing Address - State:FL
Mailing Address - Zip Code:32431-8809
Mailing Address - Country:US
Mailing Address - Phone:850-326-9104
Mailing Address - Fax:
Practice Address - Street 1:1360 BRICKYARD RD
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-6303
Practice Address - Country:US
Practice Address - Phone:850-638-1610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9218489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily