=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417856519
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAILEIGH WHEELER FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2026
-----------------------------------------------------
Last Update Date | 11/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 N POND DR
-----------------------------------------------------
City | WALLED LAKE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48390-3079
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-669-2273
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23267 VIOLET ST
-----------------------------------------------------
City | FARMINGTON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48336-3384
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-773-9120
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 4704349853
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------