Individual
BRONWYN DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 SINGLETON RIDGE RD, CONWAY, SC 29526-9142
(843) 347-7111
Mailing address
300 SINGLETON RIDGE RD, CONWAY, SC 29526-9142
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
99222
SC
363LF0000X
Family Nurse Practitioner
Primary
21624
SC
Other
Enumeration date
12/23/2017
Last updated
04/21/2021
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