Healthcare Provider Details

I. General information

NPI: 1487805669
Provider Name (Legal Business Name): LORI A DAUGHERTY-SWITZER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 11/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 REGENT BLVD STE 400
IRVING TX
75063-5808
US

IV. Provider business mailing address

3050 REGENT BLVD STE 400
IRVING TX
75063-5808
US

V. Phone/Fax

Practice location:
  • Phone: 214-689-3600
  • Fax:
Mailing address:
  • Phone: 214-689-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12131
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP009969
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: