=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073745287
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURA W MCCARRON NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2009
-----------------------------------------------------
Last Update Date | 07/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 90 TER HEUN DR STE 301
-----------------------------------------------------
City | FALMOUTH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02540-2533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-457-7922
-----------------------------------------------------
Fax | 508-548-9853
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 90 TER HEUN DR STE 301
-----------------------------------------------------
City | FALMOUTH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02540-2533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-457-7922
-----------------------------------------------------
Fax | 508-548-9853
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 214489
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------