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General NPI Number Information
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NPI Number | 1366900797
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Entity Type | Individual
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Provider Name | NICOLE ANNMARIE CASALE PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 3800 RESERVOIR RD NW
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City | WASHINGTON
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State | DC
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Zip | 20007-2113
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Country | US
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Telephone | 202-444-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 6825 WASHINGTON BLVD APT 202
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City | ARLINGTON
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State | VA
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Zip | 22213-1121
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Country | US
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Telephone | 301-928-5690
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110006556
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA200001933
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License Number State | DC
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