Healthcare Provider Details

I. General information

NPI: 1386134807
Provider Name (Legal Business Name): COURTNEY MCDONALD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 CHELSEA ST
EVERETT MA
02149-4632
US

IV. Provider business mailing address

11 ABBY ELLEN LN
PEABODY MA
01960-5043
US

V. Phone/Fax

Practice location:
  • Phone: 781-388-6200
  • Fax: 617-387-9768
Mailing address:
  • Phone: 781-254-8687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2288961
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN2288961
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: