# SAMANTHA DIANE DAUGHERTY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1184227068
- **Gender:** F
- **Credential:** FNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WM0705X | Medical-Surgical Registered Nurse | 95063542 | CA | — |
| 163WM0705X | Medical-Surgical Registered Nurse | R042508 | SD | — |
| 363L00000X | Nurse Practitioner | R49889 | ND | Yes |
| 363LF0000X | Family Nurse Practitioner | R49889 | ND | — |

## Other

- **Enumeration date:** 11/21/2020
- **Last updated:** 08/06/2021