Dougherty, Debra S

Dougherty, Debra S is an individual health care provider with primary practice located at 200 3Rd Ave W Suite 210, Bradenton FL 34205-8626. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Dougherty, Debra S can be contacted via phone (941) 792-0340.

Contact Information

Primary practice address
200 3Rd Ave W Suite 210 Bradenton FL 34205-8626
Phone: (941) 792-0340
Fax: (941) 794-2251
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71001790 Indiana
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 2258P Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 9338893 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9338893 Florida

Profile Details

NPI number 1730104837
LBN Legal business name Dougherty, Debra S
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Apr 2nd, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730104837 NPPES
Kentucky Other 2447974000 PASSPORT ADVANTAGE
Kentucky Other 7663234 PASSPORT ADVANTAGE
Kentucky MEDICAID 78001427 PASSPORT ADVANTAGE
Kentucky Other P01420776 PASSPORT ADVANTAGE
Kentucky Other 070134 PASSPORT ADVANTAGE
Kentucky Other 000000381896 PASSPORT ADVANTAGE
Kentucky MEDICAID 200404560 PASSPORT ADVANTAGE
Kentucky Other 50006753 PASSPORT ADVANTAGE
Kentucky Other Y0C29 PASSPORT ADVANTAGE

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