Provider Demographics
NPI:1700981032
Name:MACBARRON, JEAN (CNM)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:MACBARRON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 THE NEW DRIFTWAY
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-0356
Mailing Address - Country:US
Mailing Address - Phone:781-545-8103
Mailing Address - Fax:781-545-8117
Practice Address - Street 1:56 THE NEW DRIFTWAY
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-0356
Practice Address - Country:US
Practice Address - Phone:781-545-8103
Practice Address - Fax:781-545-8117
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA179407367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA59152OtherFALLON
MAMACN0282OtherBLUE CROSS BLUE SHIELD
MAMARN0256Medicare ID - Type UnspecifiedMEDICARE