Provider Demographics
NPI:1487242376
Name:DORSEY, AUDREY AKINYI (DNP, APRN, CPNP-PC)
Entity type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:AKINYI
Last Name:DORSEY
Suffix:
Gender:F
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 CEDAR RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-1531
Mailing Address - Country:US
Mailing Address - Phone:405-974-0061
Mailing Address - Fax:
Practice Address - Street 1:13630 BEAMER RD STE 108
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6037
Practice Address - Country:US
Practice Address - Phone:281-464-3780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018639363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty