Individual
CANDIS L DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 W STONE DR, SUITE 100, KINGSPORT, TN 37660-6027
(423) 247-5197
(423) 247-5254
Mailing address
105 W STONE DR, SUITE 6A, KINGSPORT, TN 37660-3365
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5007061
NC
363LF0000X
Family Nurse Practitioner
Primary
19986
TN
Other
Enumeration date
08/04/2014
Last updated
02/18/2016
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