Individual
KILEY DONITA DAUGHTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N/A
Contact information
Practice address
703 JIM BLAKE RD, JACKSONVILLE, NC 28540-7705
(910) 967-0374
(910) 469-1275
Mailing address
703 JIM BLAKE RD, JACKSONVILLE, NC 28540-7705
(910) 967-0374
(910) 469-1275
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
10/10/2024
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