Provider Demographics
NPI:1881160562
Name:MCDONOUGH, ABIGAIL DAWN (FNP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:DAWN
Last Name:MCDONOUGH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:ROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 OLD NORTH ST
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-2947
Mailing Address - Country:US
Mailing Address - Phone:518-366-6940
Mailing Address - Fax:
Practice Address - Street 1:275 SANDWICH ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2183
Practice Address - Country:US
Practice Address - Phone:508-746-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2292495363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily