Provider Demographics
NPI:1932731866
Name:MCNALLY, SALLY F (CNM)
Entity type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:F
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8261 PLATINUM ST # 2
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-4037
Mailing Address - Country:US
Mailing Address - Phone:805-804-7310
Mailing Address - Fax:
Practice Address - Street 1:168 N BRENT ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2817
Practice Address - Country:US
Practice Address - Phone:805-648-2717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-08
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236100367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife