Physician Compare National (NPI:1083089874)

HEALTHCARE PROVIDER: MEILAN L DAGUMAN AGPCNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1083089874
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961703574
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160229000756
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DAGUMAN
	Individual professional last name
Provider First Name	MEILAN
	Individual professional first name
Provider Middle Name	LIANG
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2015
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2842 E LAKE MEAD BLVD
	Group Practice or individual's line 1 address
City	NORTH LAS VEGAS
	Group Practice or individual's city
State	NV
	Group Practice or individual's state
Zip Code	890306548
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y