Provider Demographics
NPI:1295135705
Name:MCCARTHY, ELIZABETH ANN (PNP, RN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:PNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1719
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-1719
Mailing Address - Country:US
Mailing Address - Phone:508-833-0269
Mailing Address - Fax:
Practice Address - Street 1:68B ROUTE 6A
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-1719
Practice Address - Country:US
Practice Address - Phone:508-833-0269
Practice Address - Fax:508-833-1467
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2284296163W00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse