Provider Demographics
NPI:1558716860
Name:DUGGAN, MEGAN E (RN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:E
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:E
Other - Last Name:DEFROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:630 S LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1594
Mailing Address - Country:US
Mailing Address - Phone:313-683-5855
Mailing Address - Fax:
Practice Address - Street 1:630 S LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1594
Practice Address - Country:US
Practice Address - Phone:313-683-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704254582363LF0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse