MEDICARE: TONI MCCARTHY

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
1	164W00000X	Licensed Practical Nurse	2025949	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2025949	OTHER	KY	LPN

General Provider Information

NPI Number	:	1063449197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI MCCARTHY

Provider Business Mailing Address
First Line	:	411 E CHELSEA CIR APT 3
Second Line	:
City	:	FT MITCHELL
State	:	KY
Zip	:	41017-1804
Country	:	US
Telephone Number	:	859-412-0839
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 E CHELSEA CIR APT 3
Second Line	:
City	:	FT MITCHELL
State	:	KY
Zip	:	41017-1804
Country	:	US
Telephone Number	:	859-712-0839
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	04/06/2015

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Directions to “ TONI MCCARTHY ” Practice Location

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