Provider Demographics
NPI:1225703382
Name:MCNIFF, GEORGINA H (RN)
Entity Type:Individual
Prefix:
First Name:GEORGINA
Middle Name:H
Last Name:MCNIFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 S MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83001-9429
Mailing Address - Country:US
Mailing Address - Phone:914-439-3811
Mailing Address - Fax:
Practice Address - Street 1:3750 S MEADOW DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-9429
Practice Address - Country:US
Practice Address - Phone:914-439-3811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY46471163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WN1003XNursing Service ProvidersRegistered NurseNutrition SupportGroup - Single Specialty