Doctor Name: | DR. KARA DOUGHERTY |
NPI Number: | 1053330324 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DNP, FNP-C |
License Number: | 2013000290 |
Business Practice Address: | 2004 W Marler Ln Ozark, MO - 657217661 |
Business Phone Number: | 4175813006 |
Business Fax Number: | |
Mailing Address: | Po Box 4046, SPRINGFIELD |
State: | MO |
Postal Code: | 658084046 |
Phone Number: | 4172695712 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2006 |
NPI Last Update Date: | 03/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2013000290 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |