Provider Demographics
NPI:1508549064
Name:MCCARTHY, THERESA CRAIG (CRNP - FNP BC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:CRAIG
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:CRNP - FNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 W HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-1432
Mailing Address - Country:US
Mailing Address - Phone:610-213-7300
Mailing Address - Fax:
Practice Address - Street 1:53 W HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-1432
Practice Address - Country:US
Practice Address - Phone:610-213-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027920363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily