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Individual
DEBRA S DOUGHERTY
Active
Individual
DEBRA S DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001790
IN
363L00000X
Nurse Practitioner
ARNP9338893
FL
363LW0102X
Women's Health Nurse Practitioner
2258P
KY
363LW0102X
Women's Health Nurse Practitioner
9338893
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381896
ANTHEM BCBS
IN
01
—
070134
SIHO
IN
05
—
200404560
—
IN
01
—
2447974000
PASSPORT ADVANTAGE
KY
01
—
50006753
PASSPORT KY MEDICAID
KY
01
—
7663234
AETNA
—
05
—
78001427
—
KY
01
—
P01420776
RR MEDICARE
FL
01
—
Y0C29
BCBS
FL
Enumeration date
07/12/2006
Last updated
10/21/2024
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