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Individual
MARY LEADITH MCNULTY
Active
Individual
MARY LEADITH MCNULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704196438
MI
363LC1500X
Community Health Nurse Practitioner
4704196438
MI
363LP2300X
Primary Care Nurse Practitioner
4704196438
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4698876
—
MI
Enumeration date
03/12/2007
Last updated
05/13/2019
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