Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | AP30006757 | WA |
NPI | 1730131020 |
---|---|
Provider Name | Ms. Kelly M Mcinerney |
First Address | Bellingham, WA 98225 |
Second Address | Bellingham, WA 98225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 08/07/2007 |