Individual
MR. MICHAEL JAMES DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CNS
Contact information
Practice address
3400 LUTHERAN PKWY, WHEAT RIDGE, CO 80033-6035
(303) 467-4000
(303) 467-4064
Mailing address
3400 LUTHERAN PKWY, WHEAT RIDGE, CO 80033-6035
(303) 467-4000
(303) 467-4064
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
CNS-4393
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07832753
—
CO
Enumeration date
09/10/2007
Last updated
10/26/2010
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