Individual
CANDACE JEAN DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9191 GRANT ST, THORNTON, CO 80229-4361
(303) 450-4482
(303) 306-7753
Mailing address
PO BOX 173862, DENVER, CO 80217-3862
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0004132
CO
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44650060
—
CO
Enumeration date
10/24/2014
Last updated
03/20/2021
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