Provider Demographics
NPI:1942329180
Name:MCGREW, NATHANAEL SHAY (APRN, MSN, NP-C)
Entity Type:Individual
Prefix:MR
First Name:NATHANAEL
Middle Name:SHAY
Last Name:MCGREW
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Gender:M
Credentials:APRN, MSN, NP-C
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Mailing Address - Street 1:3554 HAMILTON BEND LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-7086
Mailing Address - Country:US
Mailing Address - Phone:936-242-9501
Mailing Address - Fax:281-580-5070
Practice Address - Street 1:3307 SPRING STUEBNER RD
Practice Address - Street 2:SUITE A1
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-4690
Practice Address - Country:US
Practice Address - Phone:936-242-9501
Practice Address - Fax:281-719-0027
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2014-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXSA00005363AS0400X
TXAP126769363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00005OtherLICENSE NUMBER
TXAG0914074OtherAANPCP
TX0001JROtherBLUECROSS NUMBER