Individual
MELANIE DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
399 FARMINGTON AVE, SUITE 200, FARMINGTON, CT 06032-1936
(860) 246-2071
(860) 674-4260
Mailing address
399 FARMINGTON AVE, SUITE 200, FARMINGTON, CT 06032-1936
(860) 246-2071
(860) 674-4260
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
003029
CT
363LF0000X
Family Nurse Practitioner
003029
CT
367A00000X
Advanced Practice Midwife
000268
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004243177
—
CT
01
—
1295838399
ANTHEM BLUE CROSS BLUE SHIELD
CT
Enumeration date
09/06/2006
Last updated
06/16/2015
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