Individual
FELICIA MARIE DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 350-4692
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 350-4692
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3748
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3748
STATE LICENSE
CO
05
—
57474737
—
CO
Enumeration date
07/30/2013
Last updated
03/18/2016
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