Healthcare Provider Details

I. General information

NPI: 1821037300
Provider Name (Legal Business Name): MICHELLE FAUST CALDWELL R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 SE 32ND AVE
OCALA FL
34471-5532
US

IV. Provider business mailing address

4589 NE 2ND ST
OCALA FL
34470-1492
US

V. Phone/Fax

Practice location:
  • Phone: 352-629-0137
  • Fax:
Mailing address:
  • Phone: 352-694-8199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN9165944
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: