Provider Demographics
NPI:1154637288
Name:DOTSON, WENONA E (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:WENONA
Middle Name:E
Last Name:DOTSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 OLD HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-1301
Mailing Address - Country:US
Mailing Address - Phone:615-646-1003
Mailing Address - Fax:615-646-5686
Practice Address - Street 1:211 OLD HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-1301
Practice Address - Country:US
Practice Address - Phone:615-646-1003
Practice Address - Fax:615-646-5686
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3006683OtherKENTUCKY BOARD OF NURSING
TN15165OtherTENNESSEE BOARD OF NURSING
KY7100140950Medicaid
KY7100140950Medicaid