Provider Demographics
NPI:1316231301
Name:MCCABE, POLLY ESTHER (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:POLLY
Middle Name:ESTHER
Last Name:MCCABE
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 RADCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1026
Mailing Address - Country:US
Mailing Address - Phone:781-237-6969
Mailing Address - Fax:
Practice Address - Street 1:66 RADCLIFFE RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1026
Practice Address - Country:US
Practice Address - Phone:781-237-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN194159363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health