Basic Information
Provider Information
NPI: 1194085613
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGAFFEY
FirstName: JOANNE
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 1ST DR NW
Address2:  
City: AUSTIN
State: MN
PostalCode: 559122941
CountryCode: US
TelephoneNumber: 5074337351
FaxNumber:  
Practice Location
Address1: 1000 1ST DR NW
Address2:  
City: AUSTIN
State: MN
PostalCode: 559122941
CountryCode: US
TelephoneNumber: 5074337351
FaxNumber: 5074341927
Other Information
ProviderEnumerationDate: 05/17/2012
LastUpdateDate: 09/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XR 165047-5MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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