Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 156FX1800X | MD |
NPI | 1114155165 |
---|---|
Provider Name | Barbara Ann Mckeefery |
First Address | Annapolis, MD 21401-2005 |
Second Address | Annapolis, MD 21401-2005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2009 |
Last Update Date | 29/06/2009 |