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NPI Code Detail

MEDICARE: MRS. CATHLEEN MARGARET MCCARTNEY RANCOURT R.N.

MEDICARE:  MRS. CATHLEEN MARGARET MCCARTNEY RANCOURT  R.N.
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
1163WP0200XPediatric Registered Nurse4704176205MI

General Provider Information

NPI Number : 1053584466
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CATHLEEN MARGARET MCCARTNEY RANCOURT R.N.
Provider Business Mailing Address
First Line : 7381 OLD LANTERN DR SE
Second Line :
City : CALEDONIA
State : MI
Zip : 49316-9004
Country : US
Telephone Number : 616-554-2088
Fax Number : 616-554-2377
Provider Business Practice Location Address
First Line : 2703 DEAN LAKE AVE NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49505-3958
Country : US
Telephone Number : 616-365-9160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2008
Last Update Date : 04/07/2008

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Directions to “ MRS. CATHLEEN MARGARET MCCARTNEY RANCOURT R.N.” Practice Location

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