MS. CONNIE MARIE DOCHTERMAN APRNBC NPI 1578578316

NPI Information

  • NPI: 1578578316
  • Provider Name: MS. CONNIE MARIE DOCHTERMAN, APRN,BC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1802 ELM ST
    CANTON-LAGRANGE FAMILY PRACTICE
    CANTON, MO
    ZIP 63435
  • Phone: (573) 288-5360

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NPI Details

MS. Connie Marie Dochterman, APRN,BC is a family nurse practitioner in Canton, MO with 40 years of experience. MS. Connie Marie Dochterman, APRN,BC NPI is 1578578316. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1802 ELM ST
CANTON-LAGRANGE FAMILY PRACTICE
CANTON, MO
ZIP 63435-694
Phone: (573) 288-5360
Fax: (573) 288-5361

The NPI 1578578316 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/30/2006 and was last updated on 4/19/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily100511MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1S76668MEDICARE UPINMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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