Individual
JULIE O DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2741
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
2741
SC
367500000X
Certified Registered Nurse Anesthetist
CRNA62283
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NAN436
—
SC
Enumeration date
07/21/2006
Last updated
09/13/2022
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