| Organization Name: | MCGINNIS MICA MEDICAL PC |
| NPI Number: | 1114393568 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANE MCGINNIS (FAMILY NURSE PRACTITIONER-OWNER) |
| Mailing Address: | 1550 W Elliott Ave Box 300 Beatty |
| State: | NV US |
| Postal Code: | 890030300 |
| Phone Number: | 7023264268 |
| Fax Number: | 8779916606 |
| NPI Enumeration Date: | 08/19/2015 |
| NPI Last Update Date: | 02/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APRN001078 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |