Individual
LEILA DOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
24276 166TH STREET AIRPORT ROAD, EAGLE BUTTE, SD 57625
(605) 964-7724
(605) 964-1156
Mailing address
24276 166TH STREET AIRPORT ROAD, EAGLE BUTTE, SD 57625
(605) 964-7724
(605) 964-1156
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN9357392
FL
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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