Individual
DORIS FANDOHAN
Active
Individual
DORIS FANDOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209019405
IL
363LF0000X
Family Nurse Practitioner
71008752A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71008752A
NURSE PRACTITIONER LICENSE NUMBER
IN
Enumeration date
02/08/2019
Last updated
06/06/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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