Provider Demographics
NPI:1235101239
Name:MACVAY, ANN M (NP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:MACVAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-1528
Mailing Address - Country:US
Mailing Address - Phone:814-437-7891
Mailing Address - Fax:814-432-7714
Practice Address - Street 1:1339 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-1528
Practice Address - Country:US
Practice Address - Phone:814-437-7891
Practice Address - Fax:814-432-7714
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007989363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019776390001Medicaid
PA1019776390001Medicaid