Individual
SUSAN M DOANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
254 BUCK RUN PASS, CANYON LAKE, TX 78133-4953
(916) 715-9930
Mailing address
254 BUCK RUN PASS, CANYON LAKE, TX 78133-4953
(916) 715-9930
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
910156
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UNKNOWN
—
TX
Enumeration date
04/16/2019
Last updated
04/16/2019
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