Individual
MALLORY DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
320 W 24TH ST, KEARNEY, NE 68845-5331
(308) 698-8018
Mailing address
320 W 24TH ST, KEARNEY, NE 68845-5331
(308) 698-8018
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
79156
NE
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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