Provider Demographics
NPI:1134869019
Name:DOTSTRY, KARRI A (RN, CNLCP, LNC, CCM)
Entity type:Individual
Prefix:MS
First Name:KARRI
Middle Name:A
Last Name:DOTSTRY
Suffix:
Gender:F
Credentials:RN, CNLCP, LNC, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 E 11 MILE RD STE C
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-3523
Mailing Address - Country:US
Mailing Address - Phone:586-580-7690
Mailing Address - Fax:888-578-9570
Practice Address - Street 1:3005 E 11 MILE RD STE C
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-3523
Practice Address - Country:US
Practice Address - Phone:586-580-7690
Practice Address - Fax:888-578-9570
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704219588163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1427669969OtherNPI