Provider Demographics
NPI:1801209770
Name:MCGINNIS, ABIGAIL HELEN
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:HELEN
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-446-4032
Mailing Address - Fax:814-446-4033
Practice Address - Street 1:6854 RTE 711
Practice Address - Street 2:SUITE 7
Practice Address - City:SEWARD
Practice Address - State:PA
Practice Address - Zip Code:15954-3121
Practice Address - Country:US
Practice Address - Phone:814-446-4032
Practice Address - Fax:814-446-4033
Is Sole Proprietor?:No
Enumeration Date:2014-06-08
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013173363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily