Provider Demographics
NPI:1730264961
Name:DAUGHERTY, JULIE (ARNP)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:DAUGHERTY
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9868 S STATE ROAD 7 STE 345
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-4476
Mailing Address - Country:US
Mailing Address - Phone:561-737-8584
Mailing Address - Fax:561-737-5703
Practice Address - Street 1:9868 S STATE ROAD 7 STE 345
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-4476
Practice Address - Country:US
Practice Address - Phone:561-737-8584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2887462363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAA374YMedicare PIN
FLQ74673Medicare UPIN