Jessica Renee Daugherty, RN BSN
Individual provider Active NPI Registered Nurse · Sardinia, OH
NPI 1992485593 · NPPES record last updated Jul 23, 2023
Key facts
- NPI
- 1992485593
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 285709 (OH)
- Practice address
- 166 Winchester St
Sardinia, OH 45171-9310 - Phone
- (937) 618-9731
- NPI assigned
- Jul 19, 2023
- 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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 285709 | OH | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 285709 | OH | Yes |
Addresses
Primary practice location
166 Winchester St
Sardinia, OH 45171-9310
Mailing address
PO Box 115
Sardinia, OH 45171-0115
Phone (937) 618-9731
Other providers in Sardinia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2023. 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.