MEDICARE: CHERYL MARIE MCAULIFFE RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0400X	Case Management Registered Nurse	096000333RN	OR

General Provider Information

NPI Number	:	1144968314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL MARIE MCAULIFFE RN

Provider Business Mailing Address
First Line	:	PO BOX 738
Second Line	:
City	:	MERRILL
State	:	OR
Zip	:	97633-0738
Country	:	US
Telephone Number	:	541-281-1114
Fax Number	:

Provider Business Practice Location Address
First Line	:	2225 NORTH EL DORADO BLVD.
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601
Country	:	US
Telephone Number	:	541-864-9438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2022
Last Update Date	:	05/26/2022

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