Individual
JACLYN BLAIRE DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-PMH
Contact information
Practice address
604 SOLAREX CT UNIT 201, FREDERICK, MD 21703-8655
(301) 663-8263
Mailing address
604 SOLAREX CT UNIT 201, FREDERICK, MD 21703-8655
(301) 663-8263
(301) 682-5326
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R204851
MD
Other
Enumeration date
11/03/2019
Last updated
03/04/2020
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