Healthcare Provider Details

I. General information

NPI: 1720446693
Provider Name (Legal Business Name): ERIN K MCCARTNEY P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 01/20/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LITTLE RIVER RD
KINGSTON NH
03848-3117
US

IV. Provider business mailing address

1 LITTLE RIVER RD
KINGSTON NH
03848-3117
US

V. Phone/Fax

Practice location:
  • Phone: 603-347-8810
  • Fax: 603-347-8811
Mailing address:
  • Phone: 603-347-8810
  • Fax: 603-347-8811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA5244
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1148
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: