Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | F3018501 | NY |
NPI | 1013014455 |
---|---|
Provider Name | Karen Engdahl Dugan |
First Address | Rochester, NY 14618-4714 |
Second Address | Rochester, NY 14621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |