Doctor Name: | BARBARA DOUGHERTY |
NPI Number: | 1003163577 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | SP011901 |
Business Practice Address: | 2546b Knights Rd Bensalem, PA - 190203407 |
Business Phone Number: | 2156338397 |
Business Fax Number: | |
Mailing Address: | 7863 Spring Ave, ELKINS PARK |
State: | PA |
Postal Code: | 190272619 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/14/2012 |
NPI Last Update Date: | 08/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP011901 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |