| NPI | 1063955540 |
|---|---|
| Former Name | JOHANNA MARIE MCANALLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0999134-NP) |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2024-02-13 |