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Individual

MRS. THERESA NAOMI MACDOUGALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CERTIFIED NURSE PRAC

Contact information

Practice address
531 FAUNCE CORNER RD, DARTMOUTH, MA 02747-1242
(508) 996-3991
Mailing address
531 FAUNCE CORNER RD, DARTMOUTH, MA 02747-1242
(508) 996-3991

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN03228
RI
363LF0000X
Family Nurse Practitioner
RN284223
MA
363LF0000X
Family Nurse Practitioner
SP010165
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110171739A
MA
01
1583237
GATEWAY-WMG
PA
01
2099584
HIGHMARK BLUE SHIELD
PA
01
951695
CAREFIRST MD BCBS
MD
Enumeration date
03/02/2009
Last updated
02/08/2023
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