Kristen Anne Dorough, RNFA

Individual provider Active NPI Registered Nurse First Assistant · Mammoth Lakes, CA

NPI 1730866922 · NPPES record last updated Jun 29, 2023

Key facts

NPI
1730866922
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse First Assistant 163WR0006X
License
RN75615 (NV)
Practice address
85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073
Phone
(760) 934-3311
NPI assigned
Jun 29, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN75615NVMDRegistered Nurse First Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN75615 NV Yes

Addresses

Primary practice location

85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073

Mailing address

PO Box 9045
Mammoth Lakes, CA 93546-9041
Phone (760) 709-6039

Other providers in Mammoth Lakes, CA

All providers in Mammoth Lakes, CA · Registered Nurse First Assistant in California

Sources for this page

Verify at the official NPI Registry.