Provider Demographics
NPI:1285873315
Name:DODSON-MCADOO, SHIRLEY C (RN, ANP-C)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:C
Last Name:DODSON-MCADOO
Suffix:
Gender:F
Credentials:RN, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1866
Mailing Address - Street 2:
Mailing Address - City:KILMARNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22482-1866
Mailing Address - Country:US
Mailing Address - Phone:804-435-0023
Mailing Address - Fax:804-435-0025
Practice Address - Street 1:101 HARRIS RD
Practice Address - Street 2:MEDICAL BUILDING 6
Practice Address - City:KILMARNOCK
Practice Address - State:VA
Practice Address - Zip Code:22482-3880
Practice Address - Country:US
Practice Address - Phone:804-435-0023
Practice Address - Fax:804-435-0025
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167175363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health