Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 95014719 | CA |
NPI | 1013519685 |
---|---|
Provider Name | Mrs. Alison Nicole Daugherty |
First Address | Danville, CA 94506-5812 |
Second Address | Concord, CA 94520-1858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2020 |
Last Update Date | 09/11/2020 |