MEDICARE: JILLIAN DOAN L.AC.

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	171100000X	Acupuncturist	397	NC

General Provider Information

NPI Number	:	1578988077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN DOAN L.AC.

Provider Business Mailing Address
First Line	:	1215 JONES FRANKLIN RD
Second Line	:	SUITE 202
City	:	RALEIGH
State	:	NC
Zip	:	27606-3351
Country	:	US
Telephone Number	:	919-621-3363
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 JONES FRANKLIN RD
Second Line	:	SUITE 202
City	:	RALEIGH
State	:	NC
Zip	:	27606-3351
Country	:	US
Telephone Number	:	919-621-3363
Fax Number	:

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

Provider Enumeration Date	:	02/20/2014
Last Update Date	:	05/05/2016

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