Provider Demographics
NPI:1932261385
Name:DAUGHERTY, CHERYL ELAINE (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ELAINE
Last Name:DAUGHERTY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 JESS CIR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-0692
Mailing Address - Country:US
Mailing Address - Phone:865-660-1053
Mailing Address - Fax:865-977-4162
Practice Address - Street 1:108 JESS CIR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-0692
Practice Address - Country:US
Practice Address - Phone:865-660-1053
Practice Address - Fax:865-977-4162
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000015697363LP0808X
TNRN0000173193163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse