Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1235809930 |
---|---|
Provider Name | Anne Nesmith |
First Address | Hyattsville, MD 20781-1925 |
Second Address | Hyattsville, MD 20781-1925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2021 |
Last Update Date | 15/09/2021 |