Individual
HEIDI DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, IBCLC
Contact information
Practice address
661 ROBIN DR, ELLETTSVILLE, IN 47429-1635
(812) 361-7465
Mailing address
661 ROBIN DR, ELLETTSVILLE, IN 47429-1635
(812) 361-7465
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
28138372A
IN
Other
Enumeration date
02/18/2010
Last updated
02/18/2010
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