Provider Demographics
NPI:1700407426
Name:NUNOO, JOAN N (AG-PCNP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:N
Last Name:NUNOO
Suffix:
Gender:F
Credentials:AG-PCNP
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:NAA LAMILEY
Other - Last Name:NUNOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DAMSON
Mailing Address - Street 1:1332 W HERNDON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-7118
Mailing Address - Country:US
Mailing Address - Phone:559-277-6570
Mailing Address - Fax:
Practice Address - Street 1:1332 W HERNDON AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-7118
Practice Address - Country:US
Practice Address - Phone:559-277-6570
Practice Address - Fax:559-277-6577
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ238737363L00000X, 363LP2300X
CA95017523363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty