Individual
JACQUELINE K DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
901 E 5TH ST, WASHINGTON, MO 63090-3127
(636) 239-8858
Mailing address
1615 N COMMERCIAL AVE, SAINT CLAIR, MO 63077-1019
Taxonomy
Speciality
Code
Description
License number
State
163WC3500X
Cardiac Rehabilitation Registered Nurse
Primary
096140
MO
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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