Provider Demographics
NPI:1306014543
Name:MCCARTHY, ANGEL A (RN)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:A
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25961 K BOY DR
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47022-7301
Mailing Address - Country:US
Mailing Address - Phone:937-344-3124
Mailing Address - Fax:
Practice Address - Street 1:25961 K BOY DR
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:IN
Practice Address - Zip Code:47022-7301
Practice Address - Country:US
Practice Address - Phone:937-344-3124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN498882163W00000X
OHRN49882163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty