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Individual

DORSHEA WOODFORK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
518 8TH AVE S, CLINTON, IA 52732-5610
(563) 219-2864
Mailing address
518 8TH AVE S, CLINTON, IA 52732-5610
(563) 219-2864

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P63977
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
85-4029920
HOMECARE
IA
Enumeration date
11/24/2020
Last updated
11/24/2020
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