Individual
MICAELA ROSE NANNERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-8111
Mailing address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-8111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
284024
MA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
RTL21-0038
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2020
Last updated
08/12/2021
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