Cavallacci, Micheline I

Cavallacci, Micheline I is an individual health care provider with primary practice located at 1600 Delta Waters Rd Suite 107, Medford OR 97504-9114. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Cavallacci, Micheline I can be contacted via phone (541) 858-2515.

Contact Information

Primary practice address
1600 Delta Waters Rd Suite 107 Medford OR 97504-9114
Phone: (541) 858-2515
Fax: (541) 858-2514
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA2939 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1235113994
LBN Legal business name Cavallacci, Micheline I
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235113994 NPPES
Other PA175803 MEDICAL LICENSE
MEDICAID 291580400 MEDICAL LICENSE

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