Provider Demographics
NPI:1912958398
Name:MCDONALD, WILLIAM JOSEPH (APRN/NP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:APRN/NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 CUSTER
Mailing Address - Street 2:
Mailing Address - City:NESS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67560
Mailing Address - Country:US
Mailing Address - Phone:785-798-2233
Mailing Address - Fax:785-798-3302
Practice Address - Street 1:312 CUSTER
Practice Address - Street 2:
Practice Address - City:NESS CITY
Practice Address - State:KS
Practice Address - Zip Code:67560
Practice Address - Country:US
Practice Address - Phone:785-798-2233
Practice Address - Fax:785-798-3302
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44109363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100250540AMedicaid