MEDICARE: MRS. BIANCA NICOLE CASWELL 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
1	363LF0000X	Family Nurse Practitioner	113866	NE

General Provider Information

NPI Number	:	1710640719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BIANCA NICOLE CASWELL FNP-C

Provider Business Mailing Address
First Line	:	1333 STONE RIDGE DR
Second Line	:
City	:	LOUISVILLE
State	:	NE
Zip	:	68037-6084
Country	:	US
Telephone Number	:	402-708-9402
Fax Number	:

Provider Business Practice Location Address
First Line	:	1333 STONE RIDGE DR
Second Line	:
City	:	LOUISVILLE
State	:	NE
Zip	:	68037-6084
Country	:	US
Telephone Number	:	402-708-9402
Fax Number	:

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

Provider Enumeration Date	:	10/16/2021
Last Update Date	:	10/16/2021

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