Individual
CAROL DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1324 MONTCLAIR PL, FORT ATKINSON, WI 53538-1380
(920) 723-6602
(920) 568-9885
Mailing address
1324 MONTCLAIR PL, FORT ATKINSON, WI 53538-1380
(920) 723-6602
(920) 568-9885
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
134708-030
WI
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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