MEDICARE: CASIE MCDOWELL RN

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
1	163W00000X	Registered Nurse	194241	AZ

General Provider Information

NPI Number	:	1407304520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASIE MCDOWELL RN

Provider Business Mailing Address
First Line	:	627 E SANTA FE ST
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-1636
Country	:	US
Telephone Number	:	520-709-1907
Fax Number	:

Provider Business Practice Location Address
First Line	:	627 E SANTA FE ST
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-1636
Country	:	US
Telephone Number	:	520-709-1907
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2016
Last Update Date	:	09/18/2016

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