Individual
SOPHIE KIIZA DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
340 BISHOPS FOREST DR, WALTHAM, MA 02452-8809
(781) 588-2326
Mailing address
340 BISHOPS FOREST DR, WALTHAM, MA 02452-8809
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN10006455
MA
163WH0200X
Home Health Registered Nurse
RN10006455
MA
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN10006455
MA
Other
Enumeration date
03/13/2026
Last updated
03/13/2026
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