Provider Demographics
NPI:1992388714
Name:CASEY, MICHELLE (FNTP, FDNP, CHHC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:FNTP, FDNP, CHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1837
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-1837
Mailing Address - Country:US
Mailing Address - Phone:808-468-6078
Mailing Address - Fax:
Practice Address - Street 1:73-1485 HAO PL
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-8657
Practice Address - Country:US
Practice Address - Phone:206-395-9386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date: