Provider Demographics
NPI:1184644148
Name:MCCARTHY, DEBBIE M (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:M
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W SAGAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEWISTON
Mailing Address - State:FL
Mailing Address - Zip Code:33440-3514
Mailing Address - Country:US
Mailing Address - Phone:863-983-3434
Mailing Address - Fax:863-983-6655
Practice Address - Street 1:500 W SAGAMORE AVE
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3514
Practice Address - Country:US
Practice Address - Phone:863-983-3434
Practice Address - Fax:863-983-6655
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1657452363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304990600Medicaid