Provider Demographics
NPI:1043372691
Name:MCCARTNEY, JOANNE (GNP)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:RAYMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 LAUREL AVENUE
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361
Mailing Address - Country:US
Mailing Address - Phone:209-847-0864
Mailing Address - Fax:209-847-7439
Practice Address - Street 1:700 LAUREL AVENUE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361
Practice Address - Country:US
Practice Address - Phone:209-847-0864
Practice Address - Fax:209-847-7439
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN501637363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology