1952300519 NPI number — LOIS REBECCA MCDONALD CLINICAL NURSE SPECI

Table of content: LOIS REBECCA MCDONALD CLINICAL NURSE SPECI (NPI 1952300519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952300519 NPI number — LOIS REBECCA MCDONALD CLINICAL NURSE SPECI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCDONALD
Provider First Name:
LOIS
Provider Middle Name:
REBECCA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CLINICAL NURSE SPECI
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCDONALD
Provider Other First Name:
LOIS
Provider Other Middle Name:
R.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD,APRN,BC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1952300519
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 79
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARPERS FERRY
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25425
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-886-8314
Provider Business Mailing Address Fax Number:
304-876-2939

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
129 E. GERMAN ST.
Provider Second Line Business Practice Location Address:
OFFICE #206
Provider Business Practice Location Address City Name:
SHEPERDSTOWN
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-886-8314
Provider Business Practice Location Address Fax Number:
304-876-2939
Provider Enumeration Date:
07/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364SP0808X , with the licence number:  28884 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com