Provider Demographics
NPI:1457557209
Name:CROGAN--POMILLA, NEVA L (GNP)
Entity Type:Individual
Prefix:
First Name:NEVA
Middle Name:L
Last Name:CROGAN--POMILLA
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:NEVA
Other - Middle Name:L
Other - Last Name:CROGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:GNP
Mailing Address - Street 1:7904 E GUNNING DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99212-1632
Mailing Address - Country:US
Mailing Address - Phone:520-240-0118
Mailing Address - Fax:
Practice Address - Street 1:7904 E GUNNING DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-1632
Practice Address - Country:US
Practice Address - Phone:520-240-0118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN116476363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology