Provider Demographics
NPI:1861574816
Name:MCNAY, JENNIFER A (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:MCNAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 E CATALPA ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-0202
Mailing Address - Country:US
Mailing Address - Phone:417-848-6192
Mailing Address - Fax:
Practice Address - Street 1:901 S NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65897-0001
Practice Address - Country:US
Practice Address - Phone:417-368-4000
Practice Address - Fax:417-836-4133
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105464207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206993826Medicaid
MO079013230Medicare PIN
MO126013268Medicare PIN
MOF45101Medicare UPIN