Provider Demographics
NPI:1295061356
Name:DUGAN, SARAH ELIZABETH (RN)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:DUGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:MEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:BLDG 170 INNER LOOP ROAD
Mailing Address - Street 2:RM 408B
Mailing Address - City:FORT IRWIN
Mailing Address - State:CA
Mailing Address - Zip Code:92310
Mailing Address - Country:US
Mailing Address - Phone:760-380-2317
Mailing Address - Fax:760-380-5276
Practice Address - Street 1:BLDG 170 INNER LOOP ROAD
Practice Address - Street 2:RM 408B
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310
Practice Address - Country:US
Practice Address - Phone:760-380-2317
Practice Address - Fax:760-380-5276
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000149675163W00000X
CA739452163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse