Healthcare Provider Details

I. General information

NPI: 1417997784
Provider Name (Legal Business Name): CHERYL RUTH DAGGETT WHC N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 11/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 GABRIEL DR
AUGUSTA ME
04332
US

IV. Provider business mailing address

43 GABRIEL DR
AUGUSTA ME
04332
US

V. Phone/Fax

Practice location:
  • Phone: 207-622-7524
  • Fax: 207-622-0836
Mailing address:
  • Phone: 207-622-7524
  • Fax: 207-622-0836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR018712
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: