Individual
MARY LYN DORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
600 CYPRESS ST, SULPHUR, LA 70663-5052
(337) 527-6371
Mailing address
2853 CHRISTY DR, LAKE CHARLES, LA 70611-3658
(337) 540-4963
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
234472
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2653091
—
LA
Enumeration date
02/09/2024
Last updated
03/19/2026
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