Provider Demographics
NPI:1477181543
Name:BOANCA, KERRIANN (MD)
Entity Type:Individual
Prefix:
First Name:KERRIANN
Middle Name:
Last Name:BOANCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KERRIANN
Other - Middle Name:
Other - Last Name:FINNEGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:110 IRVING ST NW STE 2A-68
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-7445
Mailing Address - Fax:202-877-9966
Practice Address - Street 1:110 IRVING ST NW STE 2A-68
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-7445
Practice Address - Fax:202-877-9966
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD210011692207RH0002X
390200000X
ORPG205706207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine