Eden Daugherty
Individual provider Active NPI Specialist · Vincennes, IN
NPI 1609360825 · NPPES record last updated Jun 20, 2018
Key facts
- NPI
- 1609360825
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 515 Bayou St
Vincennes, IN 47591-1034 - Phone
- (812) 886-6800
- NPI assigned
- Jun 20, 2018
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
515 Bayou St
Vincennes, IN 47591-1034
Mailing address
515 Bayou St
Vincennes, IN 47591-1034
Other providers in Vincennes, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.