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NPI Profile for MIRA DAUGHERTY in DANVILLE, KY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI # | 1992207088 |
|
| Status | Active | |
| Credentials | APRN (Advanced Practice Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 03/05/2018 | |
| Last updated | 11/11/2021 - About 5 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MIRA DAUGHERTY
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MIRA DAUGHERTY, APRN