Provider Demographics
NPI:1386850097
Name:MACPHERSON, CATHY MARIE (CPNP)
Entity Type:Individual
Prefix:PROF
First Name:CATHY
Middle Name:MARIE
Last Name:MACPHERSON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MRS
Other - First Name:CATHY
Other - Middle Name:MARIE
Other - Last Name:MACPHERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPNP
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:176-726-2737
Mailing Address - Fax:617-724-0702
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-2737
Practice Address - Fax:617-724-0702
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN182480363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner