Basic Information
| Provider Information | |||||||||
| NPI: | 1568573830 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAUGHTRY | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | ARNP-CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3268 66TH ST N | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337101511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274560750 | ||||||||
| FaxNumber: | 7274560751 | ||||||||
| Practice Location | |||||||||
| Address1: | 3268 66TH ST N | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337101511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274560750 | ||||||||
| FaxNumber: | 7274560751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 07/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | ARNP2512222 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 367A00000X | ARNP2512222 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.