Danielle M Dougherty, FNP-BC

Individual provider Active NPI Family Nurse Practitioner · Beverly, WV

NPI 1649859638 · NPPES record last updated Apr 6, 2021

Key facts

NPI
1649859638
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
108622 (WV)
Practice address
123 Poplar Rd
Beverly, WV 26253-1106
Phone
(304) 516-8170
NPI assigned
Apr 6, 2021
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

State licenses

LicenseStateTypeSpecialty
108622WVMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 108622 WV Yes

Addresses

Primary practice location

123 Poplar Rd
Beverly, WV 26253-1106

Mailing address

123 Poplar Rd
Beverly, WV 26253-1106
Phone (304) 516-8170

Other providers in Beverly, WV

All providers in Beverly, WV · Family Nurse Practitioner in West Virginia

Sources for this page

Verify at the official NPI Registry.