Provider Demographics
NPI:1902430770
Name:DOUGHERTY, BRITTANY NICOLE (APN)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:NICOLE
Last Name:DOUGHERTY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:NICOLE
Other - Last Name:AUSTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:180 LANGLEY RD
Mailing Address - Street 2:
Mailing Address - City:PITTSGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-2032
Mailing Address - Country:US
Mailing Address - Phone:609-417-7029
Mailing Address - Fax:
Practice Address - Street 1:65 W JIMMIE LEEDS RD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NJ
Practice Address - Zip Code:08240-9102
Practice Address - Country:US
Practice Address - Phone:609-652-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00994800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily