Individual
MANDY L MCNAMARA
Active
Individual
MANDY L MCNAMARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R181941
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R181941
STATE LICENSE
MD
Enumeration date
03/08/2016
Last updated
01/30/2018
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