Individual
JENNIFER MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
979 ROLLING HILLS DR, LAKE HAVASU CITY, AZ 86406-8575
(207) 907-9270
Mailing address
PO BOX 1599, PENOBSCOT COMMUNITY HEALTH CENTER, BANGOR, ME 04402-1599
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN62458
ME
363L00000X
Nurse Practitioner
Primary
CNP151091
ME
363LF0000X
Family Nurse Practitioner
AP10815
AZ
Other
Enumeration date
07/27/2015
Last updated
01/22/2019
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