Provider Demographics
NPI:1992073316
Name:DOKE, MADONNA LEAH (RN)
Entity type:Individual
Prefix:
First Name:MADONNA
Middle Name:LEAH
Last Name:DOKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:DOKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:521 FIR STREET
Mailing Address - Street 2:PO BOX 282
Mailing Address - City:CARLIN
Mailing Address - State:NV
Mailing Address - Zip Code:89822-0282
Mailing Address - Country:US
Mailing Address - Phone:775-754-2530
Mailing Address - Fax:
Practice Address - Street 1:1810 PINION RD
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-4393
Practice Address - Country:US
Practice Address - Phone:775-738-7178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN39034163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002904001Medicaid