| NPI | 1639577554 |
|---|---|
| Other Name | MICHELLE ANN DONNELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-76599-121) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2014039093) |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2015-11-04 |