Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. NINA DOUGHERTY
Active Sole ProprietorPediatric Nutrition · SANTA FE, NM
Registration Details
- NPI Number
- 1518162205
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 20, 2007 (18.847795775309 yrs)
- Last Updated
- Jul 8, 2007
- License
-
054 (NM)
- Sole Proprietor
- Yes
Practice Information
- Address
-
28 GENERAL SAGE DRSANTA FE, NM, 875056395Browse NM providers · Browse ZIP 87505
- Phone
- 5059881899
- Fax
- 5059881899
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.