Provider Demographics
NPI:1124593868
Name:DOUGHERTY, KAREN (NP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:DOUGHERTY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W SPRUCE AVE APT B
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08260-6017
Mailing Address - Country:US
Mailing Address - Phone:856-905-4616
Mailing Address - Fax:
Practice Address - Street 1:508 HIGH ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-1052
Practice Address - Country:US
Practice Address - Phone:609-261-8963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26802207Q00000X
SDSD-CNP002566207Q00000X
WI14147-33207Q00000X
NC5017682207Q00000X
CT10956207Q00000X
NYF35136-01207Q00000X
WV114079207Q00000X
GAGAA-NP000985207Q00000X
NJ26NJ00865400363LF0000X
NDR53236207Q00000X
PASP025833207Q00000X
VA0024184826207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine