Provider Demographics
NPI:1235579772
Name:MCGIVNEY, JEANNINE (FNP)
Entity type:Individual
Prefix:
First Name:JEANNINE
Middle Name:
Last Name:MCGIVNEY
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:JEANNINE
Other - Middle Name:
Other - Last Name:LAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 EMBARCADERO CTR STE 1900
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3723
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:1827 ADAMS MILL RD NW
Practice Address - Street 2:SUITE C
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1901
Practice Address - Country:US
Practice Address - Phone:888-663-6331
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33337795363LF0000X
DCRN1039395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03806659Medicaid
NYA400102726Medicare PIN