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NPI Code Detail

MEDICARE: CASEY LULAY FNP-C

MEDICARE: CASEY LULAY FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP60451155WA
2363L00000XNurse Practitioner201404020NP-PPOR

General Provider Information

NPI Number : 1295151686
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY LULAY FNP-C
Provider Business Mailing Address
First Line : PO BOX 118
Second Line :
City : STAYTON
State : OR
Zip : 97383-0118
Country : US
Telephone Number : 503-507-5356
Fax Number :
Provider Business Practice Location Address
First Line : 41805 STAYTON SCIO RD SE
Second Line :
City : STAYTON
State : OR
Zip : 97383-9739
Country : US
Telephone Number : 503-507-5356
Fax Number : 866-225-2708
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2014
Last Update Date : 05/31/2025

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