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Individual

MRS. ELIZABETH A DORN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
743 JEFFERSON AVE, SUITE 104, SCRANTON, PA 18510
(570) 346-4621
(570) 346-5109
Mailing address
743 JEFFERSON AVE, SUITE 104, SCRANTON, PA 18510
(570) 346-4621
(570) 346-5109

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN314718L
PA
363L00000X
Nurse Practitioner
SP005776B
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018654700006
PA
Enumeration date
05/25/2006
Last updated
07/08/2007
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