Provider Demographics
NPI:1346497906
Name:DAUGHERTY, HEIDI MAE (CNP)
Entity type:Individual
Prefix:MISS
First Name:HEIDI
Middle Name:MAE
Last Name:DAUGHERTY
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Gender:F
Credentials:CNP
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Mailing Address - Street 1:4565 DRESSLER RD NW
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2549
Mailing Address - Country:US
Mailing Address - Phone:330-493-0013
Mailing Address - Fax:330-493-6973
Practice Address - Street 1:4565 DRESSLER RD NW
Practice Address - Street 2:SUITE 111
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2549
Practice Address - Country:US
Practice Address - Phone:330-493-0013
Practice Address - Fax:330-493-6973
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2013-11-04
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Provider Licenses
StateLicense IDTaxonomies
OHNP-10102363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health