Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 52687 | MN |
NPI | 1144230889 |
---|---|
Provider Name | Anna R Mcnanley |
First Address | St Louis Park, MN 55426-4375 |
Second Address | St Louis Park, MN 55426-4375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 21/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02777420 | (05) | NY |
187468CK | PREFERRED CARE (01) | NY |
P00866685 | RAILROAD MEDICARE (01) | MN |