Lori J Dougherty

Individual provider Active NPI Personal Care Attendant · Sandstone, MN

NPI 1043497662 · NPPES record last updated Jan 25, 2008

Key facts

NPI
1043497662
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
119 Fouth St.
Sandstone, MN 55072
Phone
(320) 245-5362
Fax
(320) 245-5105
NPI assigned
Jan 25, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

119 Fouth St.
Sandstone, MN 55072

Mailing address

119 Fourth St.
Sandstone, MN 55072
Phone (320) 245-5362

Other providers in Sandstone, MN

All providers in Sandstone, MN · Personal Care Attendant in Minnesota

Sources for this page

Verify at the official NPI Registry.