Individual
MS. ALEXIS E. DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
603 CHURCH ST, DECATUR, GA 30030-2517
(404) 712-1453
Mailing address
603 CHURCH ST, DECATUR, GA 30030-2517
(404) 712-1453
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN157548
GA
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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