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NPI Code Detail

MEDICARE: CASEY KENYON MAHLE CPNP-PC

MEDICARE: CASEY KENYON MAHLE CPNP-PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner12286-NPOH
2363LP0200XPediatric Nurse Practitioner5007441NC

General Provider Information

NPI Number : 1508155169
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY KENYON MAHLE CPNP-PC
Provider Business Mailing Address
First Line : 1701 WESTCHESTER DR
Second Line : SUITE 850
City : HIGH POINT
State : NC
Zip : 27262-7008
Country : US
Telephone Number : 336-802-2400
Fax Number : 336-802-2536
Provider Business Practice Location Address
First Line : 114 KINDERTON BLVD
Second Line :
City : ADVANCE
State : NC
Zip : 27006-7302
Country : US
Telephone Number : 336-998-9742
Fax Number : 336-998-9410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2011
Last Update Date : 02/02/2015

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Directions to “ CASEY KENYON MAHLE CPNP-PC” Practice Location

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