Provider Demographics
NPI:1467868158
Name:MCCABE, COLIN (FNP)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:
Last Name:MCCABE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 MAIN ST
Mailing Address - Street 2:PO BOX 207
Mailing Address - City:COOPERS MILLS
Mailing Address - State:ME
Mailing Address - Zip Code:04341
Mailing Address - Country:US
Mailing Address - Phone:207-549-7581
Mailing Address - Fax:207-549-3439
Practice Address - Street 1:47 MAIN ST
Practice Address - Street 2:
Practice Address - City:COOPERS MILLS
Practice Address - State:ME
Practice Address - Zip Code:04341
Practice Address - Country:US
Practice Address - Phone:207-549-7581
Practice Address - Fax:207-549-3439
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP141043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily