Provider Demographics
NPI:1922811561
Name:DEEGAN, SANDRA (RN/DOULA)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:DEEGAN
Suffix:
Gender:F
Credentials:RN/DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-2622
Mailing Address - Country:US
Mailing Address - Phone:908-216-5682
Mailing Address - Fax:
Practice Address - Street 1:11 HARBOR RD
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-2622
Practice Address - Country:US
Practice Address - Phone:908-216-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO12165700374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula