Doctor Name: | JODY L MCHAIL |
NPI Number: | 1639191679 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | SP008488 |
Business Practice Address: | 132 Abigail Ln Port Matilda, PA - 168707153 |
Business Phone Number: | 8142727100 |
Business Fax Number: | |
Mailing Address: | 1730 Bristol Ave, Apt 821 STATE COLLEGE |
State: | PA |
Postal Code: | 168013071 |
Phone Number: | 8147466656 |
Fax Number: | |
NPI Enumeration Date: | 07/25/2006 |
NPI Last Update Date: | 11/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | SP008488 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |