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General NPI Number Information
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NPI Number | 1164715355
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Entity Type | Individual
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Provider Name | MICHELLE MAILE MCCASLIN APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 05/19/2011
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 10701 S 72ND ST STE 100 SUITE 100
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City | PAPILLION
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State | NE
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Zip | 68046-3427
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Country | US
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Telephone | 402-827-9421
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Fax | 402-999-8029
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Provider Business Mailing Address
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Address Line | 10701 SO. 72ND STREET SUITE 100 SUITE 100
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City | PAPILLION
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State | NE
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Zip | 68046
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Country | US
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Telephone | 402-827-9421
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Fax | 402-999-8029
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 111242
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License Number State | NE
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