Provider Demographics
NPI:1053954925
Name:MCCABE, KATIE (LNA)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:MCCABE
Suffix:
Gender:F
Credentials:LNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:NH
Mailing Address - Zip Code:03836-4937
Mailing Address - Country:US
Mailing Address - Phone:603-651-9280
Mailing Address - Fax:
Practice Address - Street 1:150 VILLAGE RD
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:NH
Practice Address - Zip Code:03836-4937
Practice Address - Country:US
Practice Address - Phone:603-651-9280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH045532-24251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health