| NPI | 1689414435 |
|---|---|
| Former Name | JEANNIE D MANAHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: GA RN240222) |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2024-05-29 |