Individual
MRS. JENNIFER GAIL DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
820 W RACE ST, KINGSTON, TN 37763-2120
(865) 376-3406
Mailing address
820 W RACE ST, KINGSTON, TN 37763-2120
(865) 376-3406
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN0000025171
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q090611
—
TN
Enumeration date
02/19/2019
Last updated
03/20/2024
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