Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 111775 | NE |
NPI | 1053700245 |
---|---|
Provider Name | Mrs. Nadia Ann Mccann |
First Address | Grand Island, NE 68801-9734 |
Second Address | Grand Island, NE 68801-9734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2015 |
Last Update Date | 26/12/2018 |