KATELYN DOLEZAL (NPI# 1356897953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356897953 |
Entity Type | Individual |
Full Name | KATELYN DOLEZAL |
Credential | M.D. |
Practice Address |
6600 Van Aalst Blvd, Bldg 9250 Fort Benning GA 31905 |
Practice Telephone | 7624082508 |
Enumeration Date | 2016-09-01 |
Last Update Date | 2016-09-01 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Street Address |
6600 VAN AALST BLVD, BLDG 9250 |
City | FORT BENNING |
State | GA |
Zip Code | 31905 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245777291 | Kenneth Earl Davis Jr. | Nurse Practitioner | 6600 Van Aalst Blvd, Bldg 9250, Martin Army Community Hospital, Fort Benning, GA 31905-6535 | 2017-01-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134741366 | Micah Elizabeth Lajoie | Specialist/Technologist | 7148 2nd Cavalry Street, Ft. Benning, GA 31905 | 2020-05-11 |
1598301384 | Tiffany Nicole Wolfe | Physical Therapist | 7446 Sightseeing Road, Bldg 2515, Ft Benning, GA 31905 | 2019-11-27 |
1790261022 | Kyle Joseph Burkardt | Dentist | Love Dental Clinic, 7101 Hoff St, Bldg 9240, Apo, AA 31905 | 2018-07-19 |
1821514449 | Rebekah Schott | Dentist | 7101 Hoff St., Fort Benning, GA 31905 | 2017-08-15 |
1043757677 | Karen Tolliver | Dental Hygienist | 7770 Sightseeing Rd, Bldg 2828, Fort Benning, GA 31905 | 2017-01-20 |
1043663636 | Vicky J. Nehl | Dental Hygienist | 11th Abn Div Rd, Bldg 3255, Fort Benning, GA 31905 | 2016-07-19 |
1376992719 | Xenia Key | Dental Assistant | 7770 Sightseeing Road, Bernheim Dental Clinic, Fort Benning, GA 31905 | 2016-06-07 |
1588013189 | Barbara Parker | Dental Assistant | 2828 Sightseeing Rd, Fort Benning, GA 31905 | 2016-06-06 |
1568811255 | Tavonna Ashley | Dental Hygienist | 7107 Hoff Street, Apo, AA 31905 | 2016-06-03 |
1770956252 | Clara Mccomb | Military Hospital | 6600 Van Aalst Blvd., Fort Benning, GA 31905 | 2015-11-05 |
Find all providers in zip 31905 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487182838 | Rebecca Davis | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd Bldg 9205, Fort Benning, GA 31905-2102 | 2017-05-30 |
1194106898 | Justin Sevy | Student in an Organized Health Care Education/Training Program | 7663 Craig Dr, Fort Benning, GA 31905-7914 | 2015-06-18 |
1508466731 | Nichelle Pascoe | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-10-27 |
1407479371 | Michael Thomas Dolan Jr. | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd Bldg 9250, Fort Benning, GA 31905-2102 | 2020-05-26 |
1619599305 | Benjamin Lampe | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd Bldg 9250, Fort Benning, GA 31905-2102 | 2020-05-15 |
1326660077 | Paige Williams | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd Bldg 9250, Fort Benning, GA 31905-2102 | 2020-05-15 |
1649892506 | Phillip Michael Scheanon | Student in an Organized Health Care Education/Training Program | Martin Army Community Hospital, 6600 Van Aalst Boulevard, Fort Benning, GA 31905 | 2020-05-14 |
1578185542 | Benjamin Elias Garcia | Student in an Organized Health Care Education/Training Program | Martin Army Community Hospital, 6600 Van Aalst Blvd, Bldg 9250, Fort Benning, GA 31905 | 2020-05-13 |
1821610940 | Jamison Frost Tate | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd Bldg 9250, Fort Benning, GA 31905-2102 | 2020-05-12 |
1902425333 | Preston Michael Anderson | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd Bldg 9250, Fort Benning, GA 31905-2102 | 2020-04-15 |
Find all providers in FORT BENNING |
City | FORT BENNING |
Zip Code | 31905 |
Please comment or provide details below to improve the information on KATELYN DOLEZAL.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.