Doctor Name: | MARCELLA MCCAULEY |
NPI Number: | 1326406273 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER |
License Number: | 4704231268 |
Business Practice Address: | 1515 Cal Dr Davison, MI - 484239016 |
Business Phone Number: | 8104968676 |
Business Fax Number: | |
Mailing Address: | 1515 Cal Dr, DAVISON |
State: | MI |
Postal Code: | 484239016 |
Phone Number: | 8104968676 |
Fax Number: | |
NPI Enumeration Date: | 02/07/2016 |
NPI Last Update Date: | 02/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 4704231268 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |