Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 077355-21 | NH |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 077355-23 | NH |
NPI | 1013413095 |
---|---|
Provider Name | Deann Opal Mcnamara |
First Address | Lebanon, NH 03756-1000 |
Second Address | Lebanon, NH 03756 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2018 |
Last Update Date | 01/08/2018 |