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Individual

KATHY MACNAK

Active
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Individual

KATHY MACNAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, FNP

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
762268
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282500206
—
TX
01
—
883N93
BCBS
TX
01
—
P01092354
RAILROAD MEDICARE
TX
Enumeration date
01/30/2006
Last updated
08/07/2014
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