Provider Demographics
NPI:1336389279
Name:DOHERTY, KAREN MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:DOHERTY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 LADYSLIPPER DR
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-2066
Mailing Address - Country:US
Mailing Address - Phone:603-292-5214
Mailing Address - Fax:
Practice Address - Street 1:49 LADYSLIPPER DR
Practice Address - Street 2:
Practice Address - City:NEWMARKET
Practice Address - State:NH
Practice Address - Zip Code:03857-2066
Practice Address - Country:US
Practice Address - Phone:603-292-5214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH33341835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist