Individual
MATTHEW DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1511 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22401-4631
(866) 389-7272
Mailing address
12991 ORLEANS ST, WOODBRIDGE, VA 22192-3723
(347) 571-1312
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024179009
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024179009
FAMILY NURSE PRACTITIONER
VA
Enumeration date
03/17/2020
Last updated
03/17/2020
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