Provider Demographics
NPI:1497235618
Name:MASAKI, CAROLINE N
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:N
Last Name:MASAKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3403 PARKMILL DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6471
Mailing Address - Country:US
Mailing Address - Phone:214-868-1365
Mailing Address - Fax:
Practice Address - Street 1:3403 PARKMILL DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-6471
Practice Address - Country:US
Practice Address - Phone:214-868-1365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343348164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse