Doctor Name: | DEBORAH DAUGHERTY |
NPI Number: | 1083784755 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 71000364A |
Business Practice Address: | 3280 E State Road 32 Westfield, IN - 460748731 |
Business Phone Number: | 6122251512 |
Business Fax Number: | |
Mailing Address: | 3280 E State Road 32, WESTFIELD |
State: | IN |
Postal Code: | 460748731 |
Phone Number: | 6122251512 |
Fax Number: | |
NPI Enumeration Date: | 11/09/2006 |
NPI Last Update Date: | 05/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71000364A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |