Individual
DIANE L DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
215 CENTRAL AVE STE 110, LOUISVILLE, KY 40208-1449
(502) 852-6479
(502) 852-6449
Mailing address
501 E BROADWAY, SUITE 290, LOUISVILLE, KY 40202-1785
(502) 217-8221
(502) 217-5056
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3002140
KY
Other
Enumeration date
05/15/2006
Last updated
04/08/2011
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