Basic Information
| Provider Information | |||||||||
| NPI: | 1104932219 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCABE | ||||||||
| FirstName: | BETH | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.N.C., M.S., N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 526 MAIN ST STE 302 | ||||||||
| Address2: | |||||||||
| City: | ACTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017203301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | 9783710522 | ||||||||
| Practice Location | |||||||||
| Address1: | 133 LITTLETON RD STE 205 | ||||||||
| Address2: | |||||||||
| City: | WESTFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018863198 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783717010 | ||||||||
| FaxNumber: | 9783710522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 01/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 143411 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | NP2484 | 01 | MA | BC/BS OF MA | OTHER | MM0463264I | 01 | MA | STATE CONTROLLED SUBSTANC | OTHER | 98107 | 01 | MA | FALLEN COMMUNITY HEALTH C | OTHER | MM0166238 | 01 | MA | FEDERAL DEA | OTHER |