Provider Demographics
NPI:1063783744
Name:MCDONALD, NANCY (CRNP, NP-C)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:CRNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 PEPPERELL PKWY
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5452
Mailing Address - Country:US
Mailing Address - Phone:334-528-7200
Mailing Address - Fax:334-528-3470
Practice Address - Street 1:2000 PEPPERELL PKWY
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5452
Practice Address - Country:US
Practice Address - Phone:334-528-7200
Practice Address - Fax:334-528-3470
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-062972363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care