Provider Demographics
NPI:1063295624
Name:MCGRATH, CASEY TANYA (RN, BSN, MSN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:TANYA
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:RN, BSN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 KILLDEER DR
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-2149
Mailing Address - Country:US
Mailing Address - Phone:508-494-9615
Mailing Address - Fax:
Practice Address - Street 1:111 NORFOLK ST
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-1703
Practice Address - Country:US
Practice Address - Phone:508-660-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily