Individual
MS. JO ANNE MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
740 COUNTY ROAD 39A, SOUTHAMPTON, NY 11968-5247
(631) 638-7702
Mailing address
650 COMMACK RD, COMMACK, NY 11725-5404
(631) 495-5295
(631) 675-2001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F301032
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02376410
—
NY
Enumeration date
07/14/2006
Last updated
09/06/2019
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