Healthcare Provider Details

I. General information

NPI: 1245364702
Provider Name (Legal Business Name): MICHELLE D CAREY-CASKEY CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 W THOMAS RD
PHOENIX AZ
85013-4407
US

IV. Provider business mailing address

7672 E SOLANO DR
SCOTTSDALE AZ
85250-6190
US

V. Phone/Fax

Practice location:
  • Phone: 602-684-3594
  • Fax: 480-281-5224
Mailing address:
  • Phone: 480-980-8206
  • Fax: 480-281-5224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN046522
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: