Provider Demographics
NPI:1427270636
Name:DYCUS, DOROTHY KAY (BSN ARNP)
Entity type:Individual
Prefix:MISS
First Name:DOROTHY
Middle Name:KAY
Last Name:DYCUS
Suffix:
Gender:F
Credentials:BSN ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 MADISON DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1322
Mailing Address - Country:US
Mailing Address - Phone:239-514-4745
Mailing Address - Fax:
Practice Address - Street 1:311 TAMIAMI TRL N
Practice Address - Street 2:SUITE 110
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5885
Practice Address - Country:US
Practice Address - Phone:239-436-6033
Practice Address - Fax:239-436-5946
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2174392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP39117Medicare UPIN
FLE6118ZMedicare ID - Type Unspecified