Provider Demographics
NPI:1710002548
Name:MACRIS, DONNA RIGNEY (CNM, MSN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:RIGNEY
Last Name:MACRIS
Suffix:
Gender:F
Credentials:CNM, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 N THORNE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-3516
Mailing Address - Country:US
Mailing Address - Phone:559-284-6395
Mailing Address - Fax:
Practice Address - Street 1:4433 N THORNE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-3516
Practice Address - Country:US
Practice Address - Phone:559-284-6395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA177367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA237446OtherREGISTER NURSE LICENSE
CA177OtherNURSE MIDWIFE CERTIFICATE