Provider Demographics
NPI:1477781078
Name:MCCARTNEY, ERIN S (PA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:S
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E WINDSOR BLVD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:VA
Mailing Address - Zip Code:23487-9442
Mailing Address - Country:US
Mailing Address - Phone:757-741-6033
Mailing Address - Fax:757-741-6033
Practice Address - Street 1:12720 MCMANUS BLVD STE 203
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4486
Practice Address - Country:US
Practice Address - Phone:757-741-6033
Practice Address - Fax:757-741-6033
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003040363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherCORVEL/CORCARE
VA1477781078Medicaid
VA10049676POtherSENTARA OPTIMA HEALTH
NC8101048Medicaid
VAPAROtherMULTIPLAN
VAPAROtherUSA MANAGED CARE
VAPAROtherTRICARE/CHAMPUS
VAPAROtherUSA MANAGED CARE