Basic Information
Provider Information
NPI: 1285251884
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DORSEY
FirstName: A'DRIANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5959 S SHERWOOD FOREST BLVD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708166038
CountryCode: US
TelephoneNumber: 2253741410
FaxNumber: 2257659196
Practice Location
Address1: 8300 CONSTANTIN BLVD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708093489
CountryCode: US
TelephoneNumber: 2253741410
FaxNumber: 2253741616
Other Information
ProviderEnumerationDate: 06/30/2020
LastUpdateDate: 08/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X323265LAN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363AS0400X323265LAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical

No ID Information.


Home