Provider Demographics
NPI:1477946366
Name:DUGGAN, MERLINA GANIGAN (OWNER)
Entity Type:Individual
Prefix:MRS
First Name:MERLINA
Middle Name:GANIGAN
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 KLEVIN STREET
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-644-0267
Mailing Address - Fax:907-868-2589
Practice Address - Street 1:243 KLEVIN STREET
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-644-0627
Practice Address - Fax:907-868-2589
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-17
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK10010983104A0625X
AK1011013104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness