Individual
LINDSAY BRAY DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 CIVIC CENTER BLVD, 3 WEST, PHILADELPHIA, PA 19104-5127
(215) 615-6868
(215) 615-3449
Mailing address
3400 CIVIC CENTER BLVD, 3 WEST, PHILADELPHIA, PA 19104-5127
(215) 615-6868
(215) 615-3449
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
LP-0000277
DE
363LA2200X
Adult Health Nurse Practitioner
Primary
SP021083
PA
Other
Enumeration date
10/01/2018
Last updated
12/10/2019
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