Provider Demographics
NPI:1578988077
Name:DOAN, JILLIAN (LAC)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:DOAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 JONES FRANKLIN RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-3351
Mailing Address - Country:US
Mailing Address - Phone:919-621-3363
Mailing Address - Fax:
Practice Address - Street 1:1215 JONES FRANKLIN RD
Practice Address - Street 2:SUITE 202
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-3351
Practice Address - Country:US
Practice Address - Phone:919-621-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC397171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist