Provider Demographics
NPI:1306968565
Name:MCDONALD, MARY ANN (MSN CRNP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MSN CRNP
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:ANN
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:579 BELL FACTORY RD
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-9610
Mailing Address - Country:US
Mailing Address - Phone:256-852-0713
Mailing Address - Fax:
Practice Address - Street 1:410 SIVLEY RD SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810
Practice Address - Country:US
Practice Address - Phone:256-536-3738
Practice Address - Fax:256-536-3737
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1096827363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner