Individual
MRS. MYRA F CACACE
Active
Individual
MRS. MYRA F CACACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP/ADM-BC, CDE
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
NP144577
MA
363LG0600X
Gerontology Nurse Practitioner
NP144577
MA
363LP2300X
Primary Care Nurse Practitioner
Primary
NP144577
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110015470A
—
MA
01
—
49852
FALLON
MA
01
—
BCNP0559
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/18/2005
Last updated
09/27/2018
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