# JENNA NICOLE DOTY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1619795614
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | MA065990 | PA | Yes |
| 363AS0400X | Surgical Physician Assistant | 7855 | CT | Yes |

## Other

- **Enumeration date:** 09/30/2024
- **Last updated:** 09/03/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | MA065990 | PENNSYLVANIA STATE BOARD OF MEDICINE | PA |