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General NPI Number Information
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NPI Number | 1447657630
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Entity Type | Individual
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Provider Name | DEBORAH DOUGHERTY CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/03/2014
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 2510 BONA RD
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City | WILMINGTON
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State | DE
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Zip | 19810-2220
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Country | US
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Telephone | 302-893-2216
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Fax | 215-707-4328
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Provider Business Mailing Address
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Address Line | 2510 BONA RD
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City | WILMINGTON
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State | DE
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Zip | 19810-2220
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Country | US
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Telephone | 302-893-2216
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Fax | 215-707-4328
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP014514
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License Number State | PA
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