Provider Demographics
NPI:1710858535
Name:PAULK, DORIE
Entity type:Individual
Prefix:
First Name:DORIE
Middle Name:
Last Name:PAULK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DORIE
Other - Middle Name:
Other - Last Name:DUBOIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:505 N FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NE
Mailing Address - Zip Code:68938-1914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:505 N FAIRFIELD AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NE
Practice Address - Zip Code:68938-1914
Practice Address - Country:US
Practice Address - Phone:402-460-8768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion