MEDICARE: KATHLEEN DOAN R.N., N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	6965	CA

General Provider Information

NPI Number	:	1447295001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN DOAN R.N., N.P.

Provider Business Mailing Address
First Line	:	331 THE CITY DR S
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-3205
Country	:	US
Telephone Number	:	714-935-7160
Fax Number	:	714-935-7494

Provider Business Practice Location Address
First Line	:	331 THE CITY DR S
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-3205
Country	:	US
Telephone Number	:	714-935-7160
Fax Number	:	714-935-7494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	07/16/2007

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