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NPI Code Detail

MEDICARE: DEBORAH DOUGHERTY CRNP

MEDICARE: DEBORAH DOUGHERTY CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerSP014514PA

General Provider Information

NPI Number : 1447657630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH DOUGHERTY CRNP
Provider Business Mailing Address
First Line : 2510 BONA RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19810-2220
Country : US
Telephone Number : 302-893-2216
Fax Number : 215-707-4328
Provider Business Practice Location Address
First Line : 2510 BONA RD
Second Line :
City : WILMINGTON
State : DE
Zip : 19810-2220
Country : US
Telephone Number : 302-893-2216
Fax Number : 215-707-4328
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2014
Last Update Date : 12/03/2014

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