Doctor Name: | WILLIAM RUSSELL MCNAIR |
NPI Number: | 1780913236 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP |
License Number: | RN160158 |
Business Practice Address: | 1896 E. Babbit Ln San Luis, AZ - 85349 |
Business Phone Number: | 9286279222 |
Business Fax Number: | 9286278315 |
Mailing Address: | Po Box 1669, SAN LUIS |
State: | AZ |
Postal Code: | 85349 |
Phone Number: | 9287226112 |
Fax Number: | 9287226113 |
NPI Enumeration Date: | 12/11/2009 |
NPI Last Update Date: | 05/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN160158 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |