Provider Demographics
NPI:1316345390
Name:DOTSON, SHERRIE L (RN)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:L
Last Name:DOTSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:592 W TELEPHONE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70611-5228
Mailing Address - Country:US
Mailing Address - Phone:337-936-9117
Mailing Address - Fax:
Practice Address - Street 1:592 W TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70611-5228
Practice Address - Country:US
Practice Address - Phone:337-936-9117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA119361163W00000X, 163WI0500X
TX675301163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163W00000XNursing Service ProvidersRegistered Nurse