Provider Demographics
NPI:1417997784
Name:DAGGETT, CHERYL RUTH (WHC NP)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:RUTH
Last Name:DAGGETT
Suffix:
Gender:F
Credentials:WHC NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 GABRIEL DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04332
Mailing Address - Country:US
Mailing Address - Phone:207-622-7524
Mailing Address - Fax:207-622-0836
Practice Address - Street 1:43 GABRIEL DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04332
Practice Address - Country:US
Practice Address - Phone:207-622-7524
Practice Address - Fax:207-622-0836
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAR018712363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME307990099Medicare PIN