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General NPI Number Information
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NPI Number | 1770587602
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Entity Type | Individual
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Provider Name | JUDITH ANN DOUGHTEN CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 250 S 21ST ST
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City | EASTON
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State | PA
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Zip | 18042-3851
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Country | US
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Telephone | 610-250-4303
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Fax |
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Provider Business Mailing Address
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Address Line | 195 BARNSLEY AVE
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006
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Country | US
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Telephone | 215-947-4721
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Fax | 215-947-6083
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN215554L
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License Number State | PA
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