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NPI Code Detail

MEDICARE: MS. TARA MARIE CASALETTO MSN-FNP

MEDICARE: MS. TARA MARIE CASALETTO MSN-FNP
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
1363LF0000XFamily Nurse Practitioner2020006031MO

General Provider Information

NPI Number : 1336003128
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TARA MARIE CASALETTO MSN-FNP
Provider Business Mailing Address
First Line : PO BOX 959354
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63195-9354
Country : US
Telephone Number : 636-497-4060
Fax Number : 636-497-4061
Provider Business Practice Location Address
First Line : 1520 WENTZVILLE PKWY
Second Line :
City : WENTZVILLE
State : MO
Zip : 63385-3408
Country : US
Telephone Number : 636-497-4060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 02/18/2026

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