Provider Demographics
NPI:1073605648
Name:MCCABE, ANN MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:MCCABE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANN MARIE
Other - Middle Name:
Other - Last Name:FRICANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:23 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:EAST TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02718-1010
Mailing Address - Country:US
Mailing Address - Phone:508-679-5222
Mailing Address - Fax:508-673-3182
Practice Address - Street 1:331 ELSBREE ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-7211
Practice Address - Country:US
Practice Address - Phone:508-837-3138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN228717363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI70588842Medicaid
RI70588842Medicaid