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NPI Code Detail

MEDICARE: DEBORAH DAUGHERTY NP

MEDICARE:   DEBORAH  DAUGHERTY  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71000364AIN
2363LF0000XFamily Nurse Practitioner873502NV

General Provider Information

NPI Number : 1083784755
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH DAUGHERTY NP
Provider Business Mailing Address
First Line : 3550 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-5867
Country : US
Telephone Number : 866-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 3550 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-5867
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 07/29/2024

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