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NPI Code Detail

MEDICARE: JACQUELINE MCCARTHY RN

MEDICARE: JACQUELINE MCCARTHY RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0809XAdult Psychiatric/Mental Health Registered Nurse4704430445MI

General Provider Information

NPI Number : 1114865615
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE MCCARTHY RN
Provider Business Mailing Address
First Line : 325 E H ST
Second Line :
City : IRON MOUNTAIN
State : MI
Zip : 49801-4760
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 325 E H ST
Second Line :
City : IRON MOUNTAIN
State : MI
Zip : 49801-4760
Country : US
Telephone Number : 906-774-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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