Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0427431 | KS |
NPI | 1003873449 |
---|---|
Provider Name | Dr. Cindy Daugherty |
First Address | Wichita, KS 67208-4501 |
Second Address | Wichita, KS 67208-4501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100191190B | (05) | KS |