Individual
HEATHER D DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 E 21ST ST, SIOUX FALLS, SD 57105-1016
(605) 322-2754
(605) 322-2727
Mailing address
800 E 21ST ST, SIOUX FALLS, SD 57105-1016
(605) 322-2754
(605) 322-2727
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R030566
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0715896
—
IA
01
—
175P1DO
MN BC PROVIDER #
MN
05
—
46022474348
—
NE
01
—
4994627
SD BC PROVIDER #
SD
05
—
5754760
—
SD
01
—
R030566
DAKOTACARE
SD
Enumeration date
07/31/2006
Last updated
03/06/2008
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