Provider Demographics
NPI:1720446693
Name:MCCARTNEY, ERIN K (PA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LITTLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03848-3117
Mailing Address - Country:US
Mailing Address - Phone:603-347-8810
Mailing Address - Fax:603-347-8811
Practice Address - Street 1:1 LITTLE RIVER RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NH
Practice Address - Zip Code:03848-3117
Practice Address - Country:US
Practice Address - Phone:603-347-8810
Practice Address - Fax:603-347-8811
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA5244363A00000X
NH1148363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE8413OtherMEDICARE, NH
MA3201392Medicaid
MAB97339Medicare UPIN
NHRE8413Medicare PIN