1649368895 NPI number — DR. NICOLE DELIGHT MCCAULEY D.C.

Table of content: DR. NICOLE DELIGHT MCCAULEY D.C. (NPI 1649368895)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649368895 NPI number — DR. NICOLE DELIGHT MCCAULEY D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCAULEY
Provider First Name:
NICOLE
Provider Middle Name:
DELIGHT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUBBELL
Provider Other First Name:
NICOLE
Provider Other Middle Name:
DELIGHT
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1649368895
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
646 SE HIGHWAY 101
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
DEPOE BAY
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97341-9668
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-614-4506
Provider Business Mailing Address Fax Number:
541-614-4507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
646 SE HIGHWAY 101
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
DEPOE BAY
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97341-9668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-614-4506
Provider Business Practice Location Address Fax Number:
541-614-4507
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  5097 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: 2005007736 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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