Susan M Doane, RN

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

910156 Issued in TX

Practice address

254 Buck Run Pass
Canyon Lake, TX 78133-4953

Phone

(916) 715-9930

NPI assigned

Apr 16, 2019

Last updated

Apr 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1447813357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 BUCK RUN PASS",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781334953",
            "telephone_number": "916-715-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 BUCK RUN PASS",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781334953",
            "telephone_number": "916-715-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOANE",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "910156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "UNKNOWN",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Registered Nurse in Canyon Lake, TX
• Providers in Canyon Lake, TX by specialty
• Pediatric Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.