Provider Demographics
NPI:1932468386
Name:NANCY A. MACY, WHCNP, PC
Entity Type:Organization
Organization Name:NANCY A. MACY, WHCNP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACY
Authorized Official - Suffix:
Authorized Official - Credentials:WHCNP
Authorized Official - Phone:503-476-8900
Mailing Address - Street 1:901 BRUTSCHER ST
Mailing Address - Street 2:D-378
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-6096
Mailing Address - Country:US
Mailing Address - Phone:503-476-8900
Mailing Address - Fax:
Practice Address - Street 1:308 VILLA RD
Practice Address - Street 2:115
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1881
Practice Address - Country:US
Practice Address - Phone:503-476-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR276365Medicaid