Individual
MRS. TIFFANY MARIE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1 MEDICAL PARK, WHEELING, WV 26003
(304) 243-3308
(304) 243-3328
Mailing address
1 MEDICAL PARK, WHEELING, WV 26003
(304) 243-3308
(304) 243-3328
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN64499
WV
363LF0000X
Family Nurse Practitioner
COA.16020-NP
OH
390200000X
Student in an Organized Health Care Education/Training Program
64499
WV
390200000X
Student in an Organized Health Care Education/Training Program
RN332952
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105340
—
OH
Enumeration date
06/17/2013
Last updated
05/27/2020
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