Adeline Dort
Individual provider Active NPI Registered Nurse · Manvel, TX
NPI 1194208017 · NPPES record last updated Sep 7, 2018
Key facts
- NPI
- 1194208017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 9489343 (FL)
- Practice address
- 65 Palm Grove Dr
Manvel, TX 77578-1524 - Phone
- (321) 278-4290
- NPI assigned
- Sep 7, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9489343 | FL | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 9489343 | FL | Yes |
Addresses
Primary practice location
65 Palm Grove Dr
Manvel, TX 77578-1524
Mailing address
65 Palm Grove Dr
Manvel, TX 77578-1524
Other providers in Manvel, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.