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Individual

MRS. CAROLYN MCDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
10288 W STATE ROUTE 66, NEWBURGH, IN 47630-7952
(812) 583-5864
Mailing address
PO BOX 249, NEWBURGH, IN 47629-0249
(812) 853-5864

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2008007900
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000609519
ANTHEM
05
200936920
IN
05
7100085550
KY
Enumeration date
10/28/2008
Last updated
08/31/2011
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