Individual
FANNY MIMI DOUGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2525 SECANE RD, SECANE, PA 19018-2815
(484) 472-3901
Mailing address
2525 SECANE RD, SECANE, PA 19018-2815
(484) 472-3901
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP022662
PA
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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