Provider Demographics
NPI:1225480106
Name:DOANE, EILEEN (RN)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:DOANE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 GIBBS ST
Mailing Address - Street 2:UNIT 419
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-0353
Mailing Address - Country:US
Mailing Address - Phone:301-461-1883
Mailing Address - Fax:
Practice Address - Street 1:155 GIBBS ST
Practice Address - Street 2:UNIT 419
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-0353
Practice Address - Country:US
Practice Address - Phone:301-461-1883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR166776163W00000X
DCRN1039258163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse