Dougherty, Kathleen
Dougherty, Kathleen is an sole proprietor health care provider with primary practice located at 1597 The Greens Way , Jacksonville Beach FL 32250-1401. She recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Dougherty, Kathleen can be contacted via phone (904) 425-9648.Contact Information
Primary practice address
1597 The Greens Way
Jacksonville Beach FL 32250-1401
Phone: (904) 425-9648
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Addiction (Substance Use Disorder) | 163WA0400X | RN9183201 | Florida |
Profile Details
| NPI number | 1508511080 |
|---|---|
| LBN Legal business name | Dougherty, Kathleen |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2022 |
| Last updated | Feb 14th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508511080 | NPPES |
| Florida | Other | 1568985406 | INSURANCE |
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