Individual
DR. JOANNA MARLISS FUNK NELMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
WILFORD HALL AMBULATORY CENTER, 1100 WILFORD HALL LOOP, JBSA-LACKLAND AFB, TX 78236-4660
(210) 292-3209
Mailing address
WILFORD HALL AMBULATORY CENTER, 1100 WILFORD HALL LOOP, JBSA-LACKLAND AFB, TX 78236-4660
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
01070440A
IN
2083A0100X
Aerospace Medicine Physician
Primary
T4564
TX
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
01070440A
IN
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
T4564
TX
Other
Enumeration date
05/13/2010
Last updated
12/30/2021
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