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NPI Code Detail

MEDICARE: KERI CAVALLO FNP-C

MEDICARE: KERI CAVALLO FNP-C
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
1363L00000XNurse Practitioner95006968CA
2363L00000XNurse Practitioner0024194424VA
3363L00000XNurse PractitionerAPRN11045458FL
4363L00000XNurse Practitioner3-002863AL
5363LF0000XFamily Nurse Practitioner95006968CA
6363L00000XNurse Practitioner0041668OH
7363L00000XNurse Practitioner5020061NC
8363LF0000XFamily Nurse Practitioner286807AZ
9363LF0000XFamily Nurse Practitioner10002048OR
10363LF0000XFamily Nurse PractitionerAP61368235WA
11363L00000XNurse Practitioner850145NV
12363LF0000XFamily Nurse Practitioner1105908TX
13363L00000XNurse PractitionerC-APN.0105702-C-NPCO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
195006968OTHERCABRN

General Provider Information

NPI Number : 1265951727
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERI CAVALLO FNP-C
Provider Business Mailing Address
First Line : 423 FAIR DR
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-6232
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 525 N TRYON ST STE 1600
Second Line :
City : CHARLOTTE
State : NC
Zip : 28202-0213
Country : US
Telephone Number : 866-849-0692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2017
Last Update Date : 03/12/2026

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Directions to “ KERI CAVALLO FNP-C” Practice Location

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