Provider Demographics
NPI:1154538288
Name:MCKAY, MAUREEN THERESE (NP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:THERESE
Last Name:MCKAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3543
Mailing Address - Country:US
Mailing Address - Phone:508-477-9674
Mailing Address - Fax:508-477-9674
Practice Address - Street 1:314 GIFFORD ST
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2945
Practice Address - Country:US
Practice Address - Phone:508-539-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA102355163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP2266Medicare ID - Type Unspecified