Provider Demographics
NPI:1568287449
Name:MCGANN, NAASHA (LMBT)
Entity type:Individual
Prefix:
First Name:NAASHA
Middle Name:
Last Name:MCGANN
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5078 HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28570-6228
Mailing Address - Country:US
Mailing Address - Phone:843-826-6398
Mailing Address - Fax:
Practice Address - Street 1:325 MIDDLE ST # B
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4986
Practice Address - Country:US
Practice Address - Phone:252-424-4244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20364225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist