Provider Demographics
NPI:1518050665
Name:MCCABE, MARTHA J (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:J
Last Name:MCCABE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 E MAYO ST
Mailing Address - Street 2:
Mailing Address - City:ONEILL
Mailing Address - State:NE
Mailing Address - Zip Code:68763-1157
Mailing Address - Country:US
Mailing Address - Phone:402-336-4125
Mailing Address - Fax:
Practice Address - Street 1:2024 W PASEWALK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4629
Practice Address - Country:US
Practice Address - Phone:402-844-3830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE441363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE37588OtherBCBS OF NE
NE22319OtherMIDLANDS CHOICE
NE22319OtherMIDLANDS CHOICE
NE274602Medicare ID - Type Unspecified
NEP00255925Medicare ID - Type UnspecifiedRAILROAD MEDICARE