Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 35061531 | OH |
NPI | 1093724486 |
---|---|
Provider Name | L Ann Nunnally |
First Address | Akron, OH 44333-1094 |
Second Address | Akron, OH 44305-2460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0025517 | LICENSE (01) | NC |
0852564 | (05) | IL |
35061531 | LICENSE (01) | OH |
AN9614783 | DEA (01) | |
D13381 | (02) |