Provider Demographics
NPI:1417346552
Name:MACVITTIE, RINNAH (FNP-BC; AGNP-C)
Entity Type:Individual
Prefix:MS
First Name:RINNAH
Middle Name:
Last Name:MACVITTIE
Suffix:
Gender:F
Credentials:FNP-BC; AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16735 GREENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WEED
Mailing Address - State:CA
Mailing Address - Zip Code:96094-9451
Mailing Address - Country:US
Mailing Address - Phone:314-308-8484
Mailing Address - Fax:
Practice Address - Street 1:2415 HIGH SCHOOL AVE STE 700
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1879
Practice Address - Country:US
Practice Address - Phone:415-848-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201500020NP-PP363LA2200X
IDNP-1524A363LA2200X
OR20160773363LF0000X
CANP95005361363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health