MEDICARE: CASEY MALICOAT APRN,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	3014454	KY
2	363L00000X	Nurse Practitioner	C-APN.0103288-C-NP	CO
3	363L00000X	Nurse Practitioner	71014933A	IN
4	163W00000X	Registered Nurse	400060	OH
5	363LF0000X	Family Nurse Practitioner	APRN.CNP.024524	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	QMP000004855095	OTHER	MOLINA
2	14435766	OTHER	CAQH
3	000001329868	OTHER	BCBS OH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881019214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY MALICOAT APRN,FNP-C

Provider Business Mailing Address
First Line	:	512 MARKET ST
Second Line	:
City	:	FELICITY
State	:	OH
Zip	:	45120-0107
Country	:	US
Telephone Number	:	513-876-5151
Fax Number	:	513-457-5008

Provider Business Practice Location Address
First Line	:	512 MARKET ST
Second Line	:
City	:	FELICITY
State	:	OH
Zip	:	45120-0107
Country	:	US
Telephone Number	:	513-876-5151
Fax Number	:	513-457-5008

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

Provider Enumeration Date	:	02/21/2014
Last Update Date	:	01/20/2026

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