Individual
DOROTHY JOY DUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, CNM
Contact information
Practice address
94125 4TH STREET, GOLD BEACH, OR 97444
(541) 247-6628
(541) 247-6629
Mailing address
PO BOX 1215, 94125 4TH STREET, GOLD BEACH, OR 97444-1215
(541) 247-6628
(541) 247-6629
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200650112NP FNP-PP
OR
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
200150025NP NMNP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278504
—
OR
01
—
891095002
REGENCE BLUECROSS
OR
01
—
P00420229
RAILROAD MEDICARE
OR
Enumeration date
09/08/2006
Last updated
04/09/2013
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