Provider Demographics
NPI:1518268911
Name:MCCARLEY, MICHELLE D (NP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:D
Last Name:MCCARLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6957 W PLANO PKWY STE 1000
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-1621
Mailing Address - Country:US
Mailing Address - Phone:972-939-8294
Mailing Address - Fax:214-731-0240
Practice Address - Street 1:6957 W PLANO PKWY STE 1000
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-1621
Practice Address - Country:US
Practice Address - Phone:972-939-8294
Practice Address - Fax:214-731-0240
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX733604363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX219624803Medicaid
TX219624802Medicaid
TX219624801Medicaid
TX219624806Medicaid
TXTXB119210Medicare PIN
TXTXB119212Medicare PIN
TX219624806Medicaid
TXTXB122650Medicare PIN