Provider Demographics
NPI:1205814936
Name:MCDONALD, PATRICIA BLINN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:BLINN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:BLINN
Other - Last Name:GARNCARZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:1439 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-3128
Mailing Address - Country:US
Mailing Address - Phone:920-312-0670
Mailing Address - Fax:
Practice Address - Street 1:1439 GROVE ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-3128
Practice Address - Country:US
Practice Address - Phone:920-312-0670
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163W00000X, 163WC0400X, 163WH0200X, 163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WC0400XNursing Service ProvidersRegistered NurseCase Management
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome Health
Not Answered163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy