Individual
DEBORAH DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
520 TRACY RD, NEW WHITELAND, IN 46184-9373
(317) 535-7447
(317) 535-0262
Mailing address
520 TRACY RD, NEW WHITELAND, IN 46184-9373
(317) 535-7447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000704
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200452810
—
IN
Enumeration date
11/01/2006
Last updated
04/21/2010
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