Provider Demographics
NPI:1275506669
Name:MARCOTTE, MARYBETH (RNC)
Entity Type:Individual
Prefix:
First Name:MARYBETH
Middle Name:
Last Name:MARCOTTE
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 RESEARCH PL STE 320
Mailing Address - Street 2:
Mailing Address - City:N CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2455
Mailing Address - Country:US
Mailing Address - Phone:978-256-1858
Mailing Address - Fax:978-788-7890
Practice Address - Street 1:20 RESEARCH PL
Practice Address - Street 2:SUITE 300
Practice Address - City:N CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2454
Practice Address - Country:US
Practice Address - Phone:978-256-1858
Practice Address - Fax:978-788-7896
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA132625363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS31558Medicare UPIN
MANP2541Medicare ID - Type Unspecified