Provider Demographics
NPI:1588387401
Name:DORSEY, STEPHEN EVERETT IV (RN)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:EVERETT
Last Name:DORSEY
Suffix:IV
Gender:M
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:74 BALLPARK DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103
Mailing Address - Country:US
Mailing Address - Phone:207-712-3784
Mailing Address - Fax:
Practice Address - Street 1:151 CAPITOL STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-6262
Practice Address - Country:US
Practice Address - Phone:207-512-8549
Practice Address - Fax:207-512-8552
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MERN57480163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse