Degagne, Mary Pat

Degagne, Mary Pat is an individual health care provider with primary practice located at 500 Doyle Park Dr Suite 100, Santa Rosa CA 95405-4558. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Degagne, Mary Pat can be contacted via phone (707) 544-6090.

Contact Information

Primary practice address
500 Doyle Park Dr Suite 100 Santa Rosa CA 95405-4558
Phone: (707) 544-6090
Fax: (707) 544-2389
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 225 California

Profile Details

NPI number 1326151374
LBN Legal business name Degagne, Mary Pat
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326151374 NPPES
California Other 366801 RN RN LICENSE

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