Betty Ann Dornbrook, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704088130 Issued in MI

Practice address

2395 W Grand Blvd
Detroit, MI 48208-1210

Phone

(313) 897-2061

NPI assigned

Sep 4, 2006

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871695312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1352 EDMUNDTON DR",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361027",
            "telephone_number": "313-882-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482081210",
            "telephone_number": "313-897-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNBROOK",
        "first_name": "BETTY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704088130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juairra Aishia Dorchy
• Doreen & Al'S Chore Services LLC
• Andrea Kay Dorman, NP
• Francine Ann Dorn, RN
• Kimberly E. Dornan, MACOM, LAC
• Amy Kiser Dorobek, CRNA
• Frederick Doromal IV
• Deborah Lynne Dorsett, M.D.
• Kimberly Dorsette, RN
• Sharon Louise Dorsette, CHW

• Adult Health Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.