# ANN MACWAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1568138394
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 310379 | NY | — |
| 363LA2200X | Adult Health Nurse Practitioner | 310379 | NY | Yes |

## Other

- **Enumeration date:** 08/20/2021
- **Last updated:** 12/27/2021