Provider Demographics
NPI:1891927786
Name:DOUGAL, SHEILA D (RN)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:D
Last Name:DOUGAL
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 1:1891 N LITCHFIELD RD APT 126
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-1609
Mailing Address - Country:US
Mailing Address - Phone:623-242-9814
Mailing Address - Fax:
Practice Address - Street 1:1891 N LITCHFIELD RD
Practice Address - Street 2:APT. 126
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-1601
Practice Address - Country:US
Practice Address - Phone:623-242-9814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ136646163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse