LEILA DOUGHERTY (NPI# 1891301420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891301420 |
| Entity Type | Individual |
| Full Name | LEILA DOUGHERTY |
| Credential | REGISTERED NURSE |
| Practice Address |
24276 166th Street Airport Road Eagle Butte SD 57625 |
| Practice Telephone | 6059647724 |
| Practice Fax Number | 6059641156 |
| Mailing Telephone | 6059647724 |
| Mailing Fax Number | 6059641156 |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WE0003X |
Registered Nurse Specialization: Emergency |
RN9357392 | FL | Nursing Service Providers |
| Street Address |
24276 166TH STREET AIRPORT ROAD |
| City | EAGLE BUTTE |
| State | SD |
| Zip Code | 57625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922374826 | Cheyenne River Sioux Tribe Behavorial Health | Psychologist | 24276 166th Street Airport Road, Box 1007, Eagle Butte, SD 57625 | 2012-03-26 |
| 1952928756 | Pelagie Mckenzie Jewett | Nurse's Aide | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2020-06-29 |
| 1528690591 | Annmarie Ducheneaux | Registered Nurse | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2020-02-07 |
| 1144874942 | Lita Marie Miller | Registered Nurse | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2019-07-30 |
| 1194101105 | Carlie M Soper | Pharmacist | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2015-08-03 |
| 1265856561 | Cheyenne River Sioux Tribe Diabetes Clinic | Clinic/Center | 24276 166th Street Airport Road, Eagle Butte, SD 57625-0590 | 2014-02-07 |
| 1609116524 | Mary Jo Dupris | Licensed Practical Nurse | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2013-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998359 | Jill M Marshall | Registered Nurse | 24279 166th St. Airport Road, Eagle Butte, SD 57625 | 2020-06-29 |
| 1871110890 | Stephen Andrew Williams | Registered Nurse | 24767 166th St, Eagle Butte, SD 57625 | 2020-06-26 |
| 1730706706 | Shannon Renee Brautigan | Registered Nurse | 24276 166th Street Airport Rd., Eagle Butte, SD 57625 | 2020-06-25 |
| 1598327827 | Lucy Manu | Pharmacist | 24276 166th Street; Airport Road, Eagle Butte, SD 57625 | 2019-07-08 |
| 1518429539 | Lisa Marie Brower | Registered Nurse | 24276 166th Street, Airport Rd., Eagle Butte, SD 57625 | 2019-04-01 |
| 1063976025 | Jeff Dixon | Pharmacist | Cheyenne River Health Center 24276 Airport Rd., 166th S, Eagle Butte, SD 57625 | 2019-01-24 |
| 1619455540 | Alycia Oster | Registered Nurse | 24276 166th St Airport Rd, Eagle Butte, SD 57625 | 2018-08-02 |
| 1447765987 | Deidra Monique Hall | Nurse's Aide | 211 S Spiel Court, Eagle Butte, SD 57625 | 2017-12-06 |
| 1295271070 | Cree Iron Cloud | Registered Nurse | #24276 Airport Rd, Eagle Butte, SD 57625 | 2017-01-17 |
| 1922452531 | Holly Mattern | Registered Nurse | 24276 166th Street Airport Rd, Eagle Bute, SD 57625 | 2016-04-20 |
| Find all providers in zip 57625 | ||||
| Taxonomy Code | 163WE0003X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Emergency |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518429539 | Lisa Marie Brower | Registered Nurse | 24276 166th Street, Airport Rd., Eagle Butte, SD 57625 | 2019-04-01 |
| 1619455540 | Alycia Oster | Registered Nurse | 24276 166th St Airport Rd, Eagle Butte, SD 57625 | 2018-08-02 |
| 1982118436 | Mellissa Jo Vig | Registered Nurse | 24276 Airport Rd. 166th Street, Eagle Butte, SD 57626 | 2017-11-20 |
| 1467068759 | Kristine Snowden | Registered Nurse | 24276 166th Street, Eagle Butte, SD 57625 | 2020-09-22 |
| 1396355913 | Tiffany Runde | Registered Nurse | 24276 Airport Rd, Eagle Butte, SD 57625-8021 | 2020-08-07 |
| 1194349035 | Eduardo Alejandro Bilbao La Vieja | Registered Nurse | 24276 Airport Rd, Eagle Butte, SD 57625-8021 | 2020-06-06 |
| 1164045308 | Katie Donnell Mandle | Registered Nurse | 24276 Airport Rd, Eagle Butte, SD 57625-8021 | 2020-05-21 |
| 1871126458 | Heather A Sierra | Registered Nurse | 24276 166 St Airport Rd, Eagle Butte, SD 97625 | 2020-02-21 |
| 1528690591 | Annmarie Ducheneaux | Registered Nurse | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2020-02-07 |
| 1457982829 | Michelle Rae Hartnagel | Registered Nurse | 24276 Airport Rd, Eagle Butte, SD 57625-8021 | 2020-02-04 |
| Find all providers in EAGLE BUTTE | ||||
| City | EAGLE BUTTE |
| Zip Code | 57625 |
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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.