MS. IDA MCCRAE FNP NPI 1003871393

Nurse Practitioner (Family) in Doniphan, MO

About IDA MCCRAE

Ida Mccrae is a provider in Doniphan, MO. The NPI number assigned to this provider is 1003871393. The practitioner's primary taxonomy code is Nurse Practitioner (363LF0000X). The provider is registered as an individual and their NPI record was last updated 6 years ago. Ida Mccrae is registered with Medicare.

NPI1003871393 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameMS. IDA MCCRAE FNP
Provider Location Address1 HOSPITAL DR DONIPHAN, MO 63935 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing AddressPO BOX 989 POPLAR BLUFF, MO 63902 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderFemale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date04-19-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date02-27-2012 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

MS. IDA MCCRAE FNP
1 HOSPITAL DR
DONIPHAN, MO
ZIP 63935
Phone: (573) 996-7148
Fax: (573) 996-4041
Get Directions

Mailing Address

MS. IDA MCCRAE FNP
PO BOX 989
POPLAR BLUFF, MO
ZIP 63902
Phone: (573) 778-0020
Fax: (573) 778-1647

Primary Taxonomy

Taxonomy Code363LF0000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationFamily
License No.086500
License StateMO

Map Location


MS. IDA MCCRAE FNP address is 1 HOSPITAL DR DONIPHAN, MO 63935

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1316902901DR. GEORGE P SAMUEL M.D.
Individual
Internal Medicine1 HOSPITAL DR
DONIPHAN, MO 63935
(573) 996-7148
1366407835DR. RICHARD E MUSSER JR. D.O.
Individual
Family Medicine1 HOSPITAL DR
DONIPHAN, MO 63935
(573) 996-7148
1942542063SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY
Organization
Clinic/Center (Rural Health)1 HOSPITAL DR
DONIPHAN, MO 63935
(573) 996-7148