Provider Demographics
NPI:1457416752
Name:CAIN, MAUREEN LOUISE (APN)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:LOUISE
Last Name:CAIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 DORI CT
Mailing Address - Street 2:
Mailing Address - City:PECATONICA
Mailing Address - State:IL
Mailing Address - Zip Code:61063
Mailing Address - Country:US
Mailing Address - Phone:815-239-2642
Mailing Address - Fax:
Practice Address - Street 1:74 BELOIT MALL
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511
Practice Address - Country:US
Practice Address - Phone:608-361-6051
Practice Address - Fax:608-361-6131
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006042363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner