Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 232684 | MA |
N | 363LG0600X | Nurse Practitioner - Gerontology | 232684 | MA |
NPI | 1043282445 |
---|---|
Provider Name | Ms. Jamie Lee Mccarthy |
First Address | Springfield, MA 01107-1610 |
Second Address | Westborough, MA 01581-1790 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 28/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8303928 | EVERCARE (01) | MA |
NP4334 | BLUE CROSS (01) | MA |
Q02351 | (02) |