Provider Demographics
NPI:1386959195
Name:DUGAN, DEBORAH FAYE (RN, ANP-C)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:FAYE
Last Name:DUGAN
Suffix:
Gender:F
Credentials:RN, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6506 COUNTRY PL
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-1252
Mailing Address - Country:US
Mailing Address - Phone:419-376-4989
Mailing Address - Fax:
Practice Address - Street 1:6506 COUNTRY PL
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-1252
Practice Address - Country:US
Practice Address - Phone:419-376-4989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2013-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704281729363LA2200X
OHCOA.11625-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNP37851Medicare PIN