Provider Demographics
NPI:1144850710
Name:CASKEY, WHITLEY NICOLE (LPN)
Entity type:Individual
Prefix:
First Name:WHITLEY
Middle Name:NICOLE
Last Name:CASKEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 LITTLE RIVER 131
Mailing Address - Street 2:
Mailing Address - City:FOREMAN
Mailing Address - State:AR
Mailing Address - Zip Code:71836-8527
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 LITTLE RIVER 131
Practice Address - Street 2:
Practice Address - City:FOREMAN
Practice Address - State:AR
Practice Address - Zip Code:71836-8527
Practice Address - Country:US
Practice Address - Phone:903-748-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL060473164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse