Provider Demographics
NPI:1982934980
Name:MCCARTHY, ELIZABETH ELLEN (NP-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ELLEN
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 SADDLE DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-8645
Mailing Address - Country:US
Mailing Address - Phone:406-206-5471
Mailing Address - Fax:406-206-4983
Practice Address - Street 1:3116 SADDLE DR
Practice Address - Street 2:SUITE 3
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-8645
Practice Address - Country:US
Practice Address - Phone:406-206-5471
Practice Address - Fax:406-206-4983
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT38901261QP2300X
MT100821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTRN 38901OtherREGISTERED NURSE
MT100821OtherNUR-APRN-LIC
MTRN 38901OtherREGISTERED NURSE
OR200950163NPOtherFAMILY NURSE PRACTITIONER LICENSE
ORF1999241OtherAMERICAN ACADEMY OF NURSE PRACTITIONER NATIONAL CERTIFICATION