Healthcare Provider Details

I. General information

NPI: 1649427501
Provider Name (Legal Business Name): MARCI MCDONALD APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2008
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4421 TIP UP TRL
EAGLE RIVER WI
54521-3317
US

IV. Provider business mailing address

4262 STATE HIGHWAY 70 E
EAGLE RIVER WI
54521-9407
US

V. Phone/Fax

Practice location:
  • Phone: 715-990-4555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number162518-030
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6054-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: