CANDIS L DAUGHERTY NP NPI 1528477569

NPI Information

NPI: 1528477569
Provider Name: CANDIS L DAUGHERTY, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
111 W STONE DR
SUITE 100
KINGSPORT, TN
ZIP 37660
Phone: (423) 247-5197
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Candis L Daugherty, NP is a family nurse practitioner in Kingsport, TN with 10 years of experience. Candis L Daugherty, NP NPI is 1528477569. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

111 W STONE DR
SUITE 100
KINGSPORT, TN
ZIP 37660-027
Phone: (423) 247-5197
Fax: (423) 247-5254

The NPI 1528477569 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/4/2014 and was last updated on 2/18/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		5007061	NORTH CAROLINA	No
2	363LF0000X	Nurse Practitioner	Family	19986	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1035I03831	MEDICARE PIN	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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