Provider Demographics
NPI:1528380508
Name:MCNABB, GARY FRANCIS (PMHNP)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:FRANCIS
Last Name:MCNABB
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 DAVIS RD APT B4
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-4723
Mailing Address - Country:US
Mailing Address - Phone:978-394-7099
Mailing Address - Fax:
Practice Address - Street 1:1261 FURNACE BROOK PKWY
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4768
Practice Address - Country:US
Practice Address - Phone:978-394-7099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN214883163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult