Provider Demographics
NPI:1316675341
Name:MCCABE, MICHAEL (RN, BSN)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MCCABE
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 CRESTVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-9772
Mailing Address - Country:US
Mailing Address - Phone:336-825-7077
Mailing Address - Fax:
Practice Address - Street 1:4372 SW SCHOOL RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8150
Practice Address - Country:US
Practice Address - Phone:336-819-2992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC284112163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool