Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | F301725-1 | NY |
N | 363LA2200X | Nurse Practitioner - Adult Health | TP005903C | PA |
NPI | 1023112463 |
---|---|
Provider Name | Mrs. Marie Brannigan |
First Address | Huntington Station, NY 11746-2857 |
Second Address | Huntington, NY 11743-3975 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 08/07/2007 |