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).
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 |
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 |
Street Address |
604 SOLAREX CT UNIT 201 |
City | FREDERICK |
State | MD |
Zip Code | 21703-8655 |
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 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861902959 | Kenny Chen | Optometrist | 5283 Corporate Dr Ste 201, Frederick, MD 21703 | 2017-10-03 |
1578934550 | Barbara Tarlowski | Physical Therapy Assistant | 347 Ballenger Center Drive, Frederick, MD 21703 | 2015-10-15 |
1679958813 | Taiji Acupuncture Clinic | Community Based Residential Treatment Facility, Mental Illness | 1411 Bluewing Ct, Frederick, MD 21703 | 2015-07-29 |
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 |
Find all providers in zip 21703 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
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 |
Find all providers in FREDERICK |
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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.