JACLYN BLAIRE DAUGHERTY


Address: 604 Solarex Ct Unit 201, Frederick, MD 21703-8655
Phone: 3016638263

JACLYN BLAIRE DAUGHERTY (NPI# 1477197424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477197424
Entity Type Individual
Full Name JACLYN BLAIRE DAUGHERTY
Credential CRNP-PMH
Practice Address 604 Solarex Ct Unit 201
Frederick
MD 21703-8655
Practice Telephone 3016638263
Mailing Telephone 3016638263
Mailing Fax Number 3016825326
Enumeration Date 2019-11-03
Last Update Date 2020-03-04
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
R204851 MD Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 604 SOLAREX CT UNIT 201
City FREDERICK
State MD
Zip Code 21703-8655

Providers in the same location

NPI Name Taxonomy Address Enumeration
1376552513 Amy Jo Dove Counselor 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2006-08-05
1477153724 Supriya Karray Social Worker 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2020-10-27
1477152692 Carla Hernandez Social Worker 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2020-10-19
1568080190 Nicole K. Nakagama Social Worker 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2020-07-09
1457902710 Matthew Jamal Thomas Social Worker 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2019-09-26
1124688205 Hillary F. Mallette Social Worker 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2019-06-19
1760048797 Allison L. Davis Social Worker 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2019-05-15
1215593504 Christopher R. Carr Social Worker 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2019-05-13
1417511684 Michael E. Comas Social Worker 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2019-04-23
1134687205 Jenna R. Santucci Social Worker 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2019-03-07
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Providers in the same zip code

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1578934550 Barbara Tarlowski Physical Therapy Assistant 347 Ballenger Center Drive, Frederick, MD 21703 2015-10-15
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1609283050 Green Ridge Behavioral Health, LLC Psychiatry & Neurology 5216 Chairmans Court, Suite 102, Frederick, MD 21703 2014-07-17
1841597705 Jennifer Anne Dye Speech-Language Pathologist 5312 Ballenger Creek Pike, Frederick, MD 21703 2011-02-11
1568794790 Andersons Community Healthcare Services Inc Nursing Care 4727 Verdana Loop, Frederick, MD 21703 2010-02-15
1962672782 Service Coordination Inc Case Management 5303 Spectrum Drive, Suite I, Frederick, MD 21703 2008-03-07
1396877189 Health and Happiness LLC Psychologist 93 S Mccain Drive, Frederick, MD 21703 2007-03-09
1275629776 Mary Bernadette Sheehy Nurse Practitioner Fmh Wellness Center 5500 Buckeystown Pike, Corpohs Prospect Plaza, Frederick, MD 21703 2006-10-04
1720185218 Rea and Derick Inc P 1835 Pharmacy 5500 Buckeystown Pk Frcs Sct Key Mall, Frederick, MD 21703 2006-09-19
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821560525 Titus Koimur Nurse Practitioner 107 Bierstadt Ct, Frederick, MD 21702-6442 2018-12-19
1508338203 Joel Griffith Nurse Practitioner 251 W Patrick St, Frederick, MD 21701-6942 2018-12-19
1831610161 William Haynes Nurse Practitioner 103 Water Land Ct., Frederick, MD 21702 2017-06-27
1235672205 Julie Ann Dagenhart Nurse Practitioner 1003 W 7th St Ste 403, Frederick, MD 21701-8532 2016-11-23
1689286197 Kelly Amike Ngenge Nurse Practitioner 107 Bierstadt Ct, Frederick, MD 21702-6442 2020-08-18
1386298768 Molly Kathryn Aitken Nurse Practitioner 1003 W 7th St Ste 403, Frederick, MD 21701-8532 2019-07-24
1457844722 Phoebe Antoinette Underwood-davis Nurse Practitioner 5301 Buckeystown Pike Ste 170, Frederick, MD 21704 2018-06-12
1730677121 Michelle Lynn Ridgeway Nurse Practitioner 400 W 7th St, Frederick, MD 21701 2018-05-01
1295270445 Carolyn Calleo Nurse Practitioner 604 Solarex Ct, Suite 201, Frederick, MD 21703-7005 2016-12-27
1043601347 Cynthia Kline Nurse Practitioner 5301 Buckeystown Pike Ste 170, Frederick, MD 21704-8380 2015-02-09
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Competitor

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City FREDERICK
Zip Code 21703

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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