NPI 1104655356

Geralyn Carol Dorn

Practitioner Respite Care Fort Atkinson, WI

Practice location

Address: 1217 Lillian St, Fort Atkinson, WI 53538-1530
Phone: (262) 613-2595

Registered specialties

Respite Care Primary

Respite Care Facility Taxonomy 385H00000X Licence D650-2836-1611-00 (WI)

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Registry record

NPI: 1104655356
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Jul 2024
Record last updated: 27 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.