Provider Demographics
NPI:1275552663
Name:MCCARRON, MARIE B (NP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:B
Last Name:MCCARRON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 PRESIDENT AVE
Mailing Address - Street 2:206
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5923
Mailing Address - Country:US
Mailing Address - Phone:508-679-6833
Mailing Address - Fax:508-678-2200
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:206
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-679-6833
Practice Address - Fax:508-678-2200
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA131896363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics