Individual
NEITA I DORAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP B-C
Contact information
Practice address
8540 105TH AVE, CANADIAN LAKES, MI 49346-9764
(231) 972-2710
(231) 972-2712
Mailing address
8540 105TH AVE, STANWOOD, MI 49346-9764
(231) 972-2710
(231) 972-2712
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704144505
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4843645
—
MI
05
—
4893736
—
MI
Enumeration date
05/16/2006
Last updated
07/09/2013
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