Individual
STEPHANIE DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
55 FRUIT ST, BLAKE 454, BOSTON, MA 02114-2621
(617) 724-1477
(617) 724-5997
Mailing address
55 FRUIT ST, BLAKE 454, BOSTON, MA 02114-2621
(617) 724-1477
(617) 724-5997
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2273518
MA
Other
Enumeration date
06/02/2014
Last updated
06/02/2014
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