Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | SP018153 | PA |
N | 363LG0600X | Nurse Practitioner - Gerontology | SP018153 | PA |
NPI | 1083123863 |
---|---|
Provider Name | Inga Macdonald |
First Address | York, PA 17402-9001 |
Second Address | York, PA 17403-5023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2017 |
Last Update Date | 18/05/2020 |