Healthcare Provider Details

I. General information

NPI: 1669331112
Provider Name (Legal Business Name): MEAGHAN DOHERTY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11890 HEALING WAY
SILVER SPRING MD
20904-7917
US

IV. Provider business mailing address

15307 GABLE RIDGE CT APT O
ROCKVILLE MD
20850-4602
US

V. Phone/Fax

Practice location:
  • Phone: 240-637-5525
  • Fax:
Mailing address:
  • Phone: 240-535-6377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR266444
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: