Doreen Opal Lue

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11001303 Issued in FL

Practice address

6855 Ashbury Dr
Lakeland, FL 33809-7818

Phone

(863) 858-6347

NPI assigned

May 23, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1154988210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6855 ASHBURY DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338097818",
            "telephone_number": "863-858-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6855 ASHBURY DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338097818",
            "telephone_number": "863-858-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUE",
        "first_name": "DOREEN",
        "middle_name": "OPAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11001303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.