Provider Demographics
NPI:1760779250
Name:DUGUID, DANA
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:DUGUID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 1/2 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MOSINEE
Mailing Address - State:WI
Mailing Address - Zip Code:54455-1416
Mailing Address - Country:US
Mailing Address - Phone:715-846-8812
Mailing Address - Fax:
Practice Address - Street 1:203 1/2 2ND ST
Practice Address - Street 2:
Practice Address - City:MOSINEE
Practice Address - State:WI
Practice Address - Zip Code:54455-1416
Practice Address - Country:US
Practice Address - Phone:715-846-8812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI313591164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse