Individual
JENNY MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016
(602) 263-1200
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1200
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA0306
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
999998
—
AZ
01
—
P00688569
RAILROAD MEDICARE
TX
Enumeration date
03/28/2006
Last updated
04/18/2019
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