Provider Demographics
NPI:1700384773
Name:MCCREA, MARCELLINE SHEILA
Entity type:Individual
Prefix:
First Name:MARCELLINE
Middle Name:SHEILA
Last Name:MCCREA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 SKYVIEW DR UNIT 1187
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-5012
Mailing Address - Country:US
Mailing Address - Phone:800-682-4817
Mailing Address - Fax:833-728-8697
Practice Address - Street 1:637 W MARKET CIR # 336
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-4124
Practice Address - Country:US
Practice Address - Phone:800-682-4817
Practice Address - Fax:833-728-8697
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide