| NPI | 1962079624 |
|---|---|
| Former Name | ANDREA DONNELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95019543) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 812522) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2022-01-11 |