Judith McCaul, PNP
Individual provider Active NPI Pediatric Nurse Practitioner · Potosi, MO
NPI 1528306552 · NPPES record last updated Dec 15, 2014
Key facts
- NPI
- 1528306552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 2013001299 (MO)
- Practice address
- 1 Southtowne Dr
Potosi, MO 63664-5729 - Phone
- (573) 438-9355
- NPI assigned
- Jan 25, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Health Solutions LLC | Past |
Accepting new patients | |
| Midwest Health Solutions LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 2013001299 | MO | Yes |
Addresses
Primary practice location
1 Southtowne Dr
Potosi, MO 63664-5729
Mailing address
1 Southtowne Dr
Potosi, MO 63664-5729
Phone (573) 438-9355
Other providers in Potosi, MO
- Carolyn Coyne Maryan
- Christopher Ryan Massey
- Heather Renee Mathieson
- Stephen McKown Matthews
- Tiara Michele McCarthy
- Jensen Ryan McGinness
- Tommi McMahan
- Nancy Lee McNail
- Carrie Marie Mercer
- Midwest Health Solutions LLC
All providers in Potosi, MO · Pediatric Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.