1285918011 NPI number — HANNAH NAGLE MCCABE ARNP

Table of content: HANNAH NAGLE MCCABE ARNP (NPI 1285918011)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285918011 NPI number — HANNAH NAGLE MCCABE ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCABE
Provider First Name:
HANNAH
Provider Middle Name:
NAGLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NAGLE
Provider Other First Name:
HANNAH
Provider Other Middle Name:
ALLYN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP, RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285918011
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1624 S I ST
Provider Second Line Business Mailing Address:
STE 204
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98405-5016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-752-8882
Provider Business Mailing Address Fax Number:
253-590-0260

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1624 S I ST
Provider Second Line Business Practice Location Address:
STE 204
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405-5016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-752-8882
Provider Business Practice Location Address Fax Number:
253-590-0260
Provider Enumeration Date:
09/28/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  AP60239531 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163W00000X , with the licence number: RN60239530 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0308786 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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