Provider Demographics
NPI:1538215702
Name:DOUGE, DIANA J (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:J
Last Name:DOUGE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MR
Other - First Name:GARY
Other - Middle Name:J
Other - Last Name:DOUGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7712 KENSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-8627
Mailing Address - Country:US
Mailing Address - Phone:419-470-7715
Mailing Address - Fax:
Practice Address - Street 1:7712 KENSINGTON RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-8627
Practice Address - Country:US
Practice Address - Phone:419-470-7715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator