Provider Demographics
NPI:1346277852
Name:DAUGHERTY, BERNICE (MSN, APRN, BC)
Entity Type:Individual
Prefix:
First Name:BERNICE
Middle Name:
Last Name:DAUGHERTY
Suffix:
Gender:F
Credentials:MSN, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 HIGHWAY 28
Mailing Address - Street 2:
Mailing Address - City:MCCORMICK
Mailing Address - State:SC
Mailing Address - Zip Code:29835
Mailing Address - Country:US
Mailing Address - Phone:864-852-2511
Mailing Address - Fax:
Practice Address - Street 1:204 HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:MCCORMICK
Practice Address - State:SC
Practice Address - Zip Code:29835
Practice Address - Country:US
Practice Address - Phone:864-852-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPRN2367163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory