Provider Demographics
NPI:1649953688
Name:MCCAULEY, KIRSTEN L
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:L
Last Name:MCCAULEY
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 1:13998 ROAD T13
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS GROVE
Mailing Address - State:OH
Mailing Address - Zip Code:45830-9281
Mailing Address - Country:US
Mailing Address - Phone:419-516-7614
Mailing Address - Fax:
Practice Address - Street 1:11664 ROAD Z
Practice Address - Street 2:
Practice Address - City:COLUMBUS GROVE
Practice Address - State:OH
Practice Address - Zip Code:45830-9720
Practice Address - Country:US
Practice Address - Phone:419-615-3856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker