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General NPI Number Information
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NPI Number | 1245629815
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Entity Type | Individual
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Provider Name | KELSEY LYNN DAUGHERTY DNP, RN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/20/2015
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 7636 S 78TH ST
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City | LINCOLN
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State | NE
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Zip | 68516-4023
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Country | US
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Telephone | 816-666-4201
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Fax |
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Provider Business Mailing Address
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Address Line | 7636 S 78TH ST
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City | LINCOLN
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State | NE
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Zip | 68516-4023
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Country | US
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Telephone | 816-666-4201
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 53-76665-061
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 13-119579-061
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License Number State | KS
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