MEDICARE: DAGUSE DONACIN NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R205219	MD
2	363LF0000X	Family Nurse Practitioner	R205219	MD

General Provider Information

NPI Number	:	1538614516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAGUSE DONACIN NP

Provider Business Mailing Address
First Line	:	712 H ST NE STE 8919
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3627
Country	:	US
Telephone Number	:	202-800-8919
Fax Number	:	771-717-8669

Provider Business Practice Location Address
First Line	:	712 H ST NE STE 8919
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3627
Country	:	US
Telephone Number	:	202-800-8919
Fax Number	:	771-717-8669

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

Provider Enumeration Date	:	08/19/2016
Last Update Date	:	12/10/2025

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