Provider Demographics
NPI:1053584466
Name:MCCARTNEY RANCOURT, CATHLEEN MARGARET (RN)
Entity type:Individual
Prefix:MRS
First Name:CATHLEEN
Middle Name:MARGARET
Last Name:MCCARTNEY RANCOURT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:7381 OLD LANTERN DR SE
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-9004
Mailing Address - Country:US
Mailing Address - Phone:616-554-2088
Mailing Address - Fax:616-554-2377
Practice Address - Street 1:2703 DEAN LAKE AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-3958
Practice Address - Country:US
Practice Address - Phone:616-365-9160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704176205163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics