Basic Information
Provider Information
NPI: 1073576518
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DORN
FirstName: CYNTHIA
MiddleName: JOY
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
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OtherLastName:  
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Mailing Information
Address1: 1335 HEATHBROOK CIR
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288032474
CountryCode: US
TelephoneNumber: 8286844678
FaxNumber:  
Practice Location
Address1: 1100 TUNNEL RD
Address2: VA MEDICAL CENTER, DEPT OF ANESTHESIA
City: ASHEVILLE
State: NC
PostalCode: 288052043
CountryCode: US
TelephoneNumber: 8282987911
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/07/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X118104NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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