Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | SP009092 | PA |
N | 363LA2100X | Nurse Practitioner - Acute Care | 0024165512 | VA |
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP009092 | PA |
NPI | 1003918392 |
---|---|
Provider Name | Mr. Dennis B. Macdougall |
First Address | York, PA 17404-9033 |
Second Address | York, PA 17408-8815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 28/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q16898 | (02) |