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General NPI Number Information
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NPI Number | 1861869513
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Entity Type | Individual
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Provider Name | SANDRA DUGGAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 04/06/2018
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Provider Practice Location Address
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Address Line | 400 PILGRIM BLVD
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City | HARTFORD CITY
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State | IN
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Zip | 47348-1382
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Country | US
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Telephone | 765-348-5776
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Fax | 765-348-3088
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Provider Business Mailing Address
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Address Line | 1200 W WHITE RIVER BLVD RCS PROVIDER ENROLLMENT
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City | MUNCIE
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State | IN
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Zip | 47303-4988
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Country | US
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Telephone | 765-254-4009
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Fax | 765-284-7813
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 28192064A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71005780A
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License Number State | IN
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