Healthcare Provider Details

I. General information

NPI: 1407767379
Provider Name (Legal Business Name): ANNA KATHRYN DAUGHTREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 MICCOSUKEE RD
TALLAHASSEE FL
32308-5054
US

IV. Provider business mailing address

923 JOHN CROSBY RD
ADEL GA
31620-8934
US

V. Phone/Fax

Practice location:
  • Phone: 850-431-1155
  • Fax:
Mailing address:
  • Phone: 229-507-3838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN11049148
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP311565
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: