Provider Demographics
NPI:1043618325
Name:MCCABE, EMILY (LPN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MCCABE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 GRAND AVE APT #301
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13905-0001
Mailing Address - Country:US
Mailing Address - Phone:607-345-9129
Mailing Address - Fax:
Practice Address - Street 1:42 GRAND AVE APT #301
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13905-0001
Practice Address - Country:US
Practice Address - Phone:607-345-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252250-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse