Provider Demographics
NPI:1447740394
Name:MCCABE, KATHERINE ROSE (RN, BSN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ROSE
Last Name:MCCABE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3252
Mailing Address - Country:US
Mailing Address - Phone:413-734-5200
Mailing Address - Fax:413-734-5226
Practice Address - Street 1:604 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-4200
Practice Address - Country:US
Practice Address - Phone:413-734-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN205331163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator