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Individual

MYKALA CORA CARACCILO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DNP, FNP-C

Contact information

Practice address
4000 CAMBRIDGE ST, KANSAS CITY, KS 66160-8501
(913) 588-1227
Mailing address
1200 JOSHUA CT, LANSING, KS 66043-5212
(913) 702-2483

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13-157385-052
KS
363LF0000X
Family Nurse Practitioner
2026011787
MO
363LF0000X
Family Nurse Practitioner
Primary
53-85339-052
KS

Other

Enumeration date
11/18/2024
Last updated
04/03/2026
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