Provider Demographics
NPI:1427066273
Name:DOGGETTE, LA-SHUNN (ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LA-SHUNN
Middle Name:
Last Name:DOGGETTE
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1631
Mailing Address - Country:US
Mailing Address - Phone:863-606-5937
Mailing Address - Fax:863-606-5936
Practice Address - Street 1:3200 SHAKERAG HL
Practice Address - Street 2:SUITE A
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6524
Practice Address - Country:US
Practice Address - Phone:770-408-0184
Practice Address - Fax:770-632-7747
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002026363LA2100X
GARN116950363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care