Aleta M Dorm, LPN
Individual provider Active NPI Licensed Practical Nurse · King George, VA
NPI 1972019180 · NPPES record last updated Dec 26, 2017
Key facts
- NPI
- 1972019180
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 0002082631 (VA)
- Practice address
- 11399 Ianthas Way
King George, VA 22485-2452 - Phone
- (717) 318-9681
- NPI assigned
- Dec 26, 2017
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0002082631 | VA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 0002082631 | VA | Yes |
Addresses
Primary practice location
11399 Ianthas Way
King George, VA 22485-2452
Mailing address
11399 Ianthas Way
King George, VA 22485-2452
Other providers in King George, VA
- Rushvi Shailesh Desai
- Amy Hargrave Dickerson
- Linda Wiley Dicola
- Dominion Medical Center, LLC
- James William Donahue
- Amber Dorsey
- Randy Dumornay
- Sara K Dunn
- Elizabeth Withers Dzula
- Wajahat Syed Efridi
All providers in King George, VA · Licensed Practical Nurse in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2017. 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.