Individual
MRS. MARY CLAIRE MACINNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-B.C., M.S.N
Contact information
Practice address
220 W ELLSWORTH ST, MIDLAND, MI 48640-5194
(989) 832-6769
Mailing address
220 W ELLSWORTH ST, MIDLAND, MI 48640-5194
(989) 832-6769
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704183515
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704183515
STATE LICENSE
MI
Enumeration date
08/02/2012
Last updated
08/02/2012
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