Provider Demographics
NPI:1659790483
Name:MACSAI, EVA REBECCA (CRNP)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:REBECCA
Last Name:MACSAI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:
Other - Last Name:BILDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3124 WILLOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-6610
Mailing Address - Country:US
Mailing Address - Phone:201-925-4846
Mailing Address - Fax:928-445-7095
Practice Address - Street 1:3124 WILLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-6610
Practice Address - Country:US
Practice Address - Phone:928-445-7085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013780363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP7831OtherAVD PRACTITIONER
AZRN192264OtherRN