Individual
AIMEE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP-C
Contact information
Practice address
4202 E FOWLER AVE, SHS100, TAMPA, FL 33620-6750
(813) 974-2331
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN3392062
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008025700
—
FL
01
—
Y0KV2
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/20/2011
Last updated
01/04/2024
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