Provider Demographics
NPI:1043650955
Name:MCCARTHY, STEPHANIE C (RN, APN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:C
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:RN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CLARA MAASS DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3550
Mailing Address - Country:US
Mailing Address - Phone:973-450-2000
Mailing Address - Fax:973-450-2644
Practice Address - Street 1:1 CLARA MAASS DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:973-450-2000
Practice Address - Fax:973-450-2644
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00414200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health