Provider Demographics
NPI:1386357416
Name:MCCARTHY, SUSAN M (APRN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2375 VANDERBILT BEACH RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2653
Mailing Address - Country:US
Mailing Address - Phone:239-596-4577
Mailing Address - Fax:
Practice Address - Street 1:2375 VANDERBILT BEACH RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2653
Practice Address - Country:US
Practice Address - Phone:781-738-4604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023764363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily