Provider Demographics
NPI:1881238830
Name:MCCABE, ELLEN SUE (RN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:SUE
Last Name:MCCABE
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 242
Mailing Address - Street 2:
Mailing Address - City:COTUIT
Mailing Address - State:MA
Mailing Address - Zip Code:02635-0242
Mailing Address - Country:US
Mailing Address - Phone:774-810-9441
Mailing Address - Fax:
Practice Address - Street 1:255 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1854
Practice Address - Country:US
Practice Address - Phone:774-470-8907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-03
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA241338163WH1000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH1000XNursing Service ProvidersRegistered NurseHospice