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Individual
MR. JUSTIN D DOUGLAS
Active
Individual
MR. JUSTIN D DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, FNP, CNS, APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
68193
NM
163W00000X
Registered Nurse
95191512
CA
363LF0000X
Family Nurse Practitioner
358600
NY
363LF0000X
Family Nurse Practitioner
Primary
68193
NM
364S00000X
Clinical Nurse Specialist
68193
NM
364SC0200X
Critical Care Medicine Clinical Nurse Specialist
1180827
TX
Other
Enumeration date
01/16/2020
Last updated
03/26/2026
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