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NPI Code Detail

MEDICARE: MS. CORLYN MARIE CASPERS NP

MEDICARE: MS. CORLYN MARIE CASPERS NP
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
1363LA2200XAdult Health Nurse Practitioner086000066N3OR
2363LA2200XAdult Health Nurse Practitioner086000066N3ANP-PPOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780662296
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CORLYN MARIE CASPERS NP
Provider Business Mailing Address
First Line : 8495 CRATER LAKE HWY
Second Line : VA SOUTHERN OREGON
City : WHITE CITY
State : OR
Zip : 97503-3011
Country : US
Telephone Number : 541-826-2111
Fax Number : 541-830-7550
Provider Business Practice Location Address
First Line : 8495 CRATER LAKE HWY
Second Line : VA SOUTHERN OREGON
City : WHITE CITY
State : OR
Zip : 97503-3011
Country : US
Telephone Number : 541-826-2111
Fax Number : 541-830-7550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2006
Last Update Date : 06/10/2015

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