Individual
KELLY ANN DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
55 FRUIT ST, GRB 444, BOSTON, MA 02114-2621
(617) 461-8029
Mailing address
95 WALDEMAR AVE, WINTHROP, MA 02152-2346
(617) 461-8029
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN237716
MA
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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