# DEBRA S DOUGHERTY

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

## Provider details

- **NPI number:** 1730104837
- **Gender:** F
- **Credential:** ARNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 71001790 | IN | Yes |
| 363L00000X | Nurse Practitioner | ARNP9338893 | FL | — |
| 363LW0102X | Women's Health Nurse Practitioner | 2258P | KY | — |
| 363LW0102X | Women's Health Nurse Practitioner | 9338893 | FL | — |

## Other

- **Enumeration date:** 07/12/2006
- **Last updated:** 10/21/2024

## 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 |