NPI | 1467921130 |
---|---|
Former Name | KATHERINE IVEY DOUGHERTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11020374) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308671) |
Enumeration Date | 2018-11-25 |
Last Update Date | 2023-07-06 |