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Individual
MARANDA GOURLEY
Active
Individual
MARANDA GOURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, MSN, PNP-PC
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
153396
CT
363LP0200X
Pediatric Nurse Practitioner
Primary
9041
CT
Other
Enumeration date
03/02/2020
Last updated
02/09/2021
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