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Contact Information

MARY MCENELLY, PA C
120 LABREE AVENUE SOUTH
NORTHWEST MEDICAL CENTER MENTAL HEALTH DIVISION
THIEF RIVER FALLS, MN56701
 Phone: 218-683-4351
 Fax: 218-683-4362
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MARY MCENELLY · (Female)

NPI Number 1215993811
Status Active
Credentials PA C
Entity Individual
Enumeration date 04/22/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # 9315
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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