NPIMap

Individual provider Active NPI

Nicole Elizabeth Doan

  • Women's Health Nurse Practitioner
  • Wellsboro, PA
National Provider Identifier
1336770478
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
SP025195 Issued in PA
Practice address
7 Water St
Wellsboro, PA 16901-1126
Phone
(570) 723-1010
NPI assigned
Jan 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 421424 NY
Women's Health Nurse Practitioner 363LW0102X SP025195 PA Primary

Addresses

Primary practice location

7 Water St
Wellsboro, PA 16901-1126

Mailing address

40 W Wellsboro St
Mansfield, PA 16933-1411
Phone (570) 662-1945

Other practice location 1

1005 Walnut St
Elmira, NY 14901-1007
Phone (607) 734-3968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240618001716 PA Practitioner - Nurse Practitioner 2163965294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Penn Comprehensive Health Services 43 clinicians

Practice addresses (Care Compare)

7 Water St
Wellsboro, PA 16901-1126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
421424NYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Penn Comprehensive Health Services Current Accepting new patients
North Penn Comprehensive Health Services CurrentSince Jun 17, 2024 Accepting new patients
North Penn Comprehensive Health Services CurrentSince Jun 17, 2024 Accepting new patients
Doan Med LLC Current Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients

Locations

6 Riverside Plz
Blossburg, PA 16912
Phone (570) 638-2174

103 Forestview Ave
Elkland, PA 16920
Phone (814) 258-5117

32 E Lawrence Rd
Lawrenceville, PA 16929
Phone (570) 827-0125

40 W Wellsboro St
Mansfield, PA 16933
Phone (570) 662-1945

416 S Main St
Mansfield, PA 16933
Phone (570) 662-1900

410 Main St
Ste 102
Towanda, PA 18848
Phone (570) 266-5882

45 Mud Creek Rd
Troy, PA 16947
Phone (570) 297-3746

7 Water St
Wellsboro, PA 16901
Phone (570) 724-1010

236 E Main St
Westfield, PA 16950
Phone (814) 367-5911

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1336770478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W WELLSBORO ST",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169331411",
            "telephone_number": "570-662-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WATER ST",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011126",
            "telephone_number": "570-723-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149011007",
            "country_code": "US",
            "telephone_number": "607-734-3968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOAN",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "421424",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "SP025195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellsboro, PA

Sources for this page

Verify at the official NPI Registry.