MEDICARE: GARRETT STEPHEN CASEY CRNA

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	367500000X	Certified Registered Nurse Anesthetist	239710	LA
2	367500000X	Certified Registered Nurse Anesthetist	131967	WI
3	367500000X	Certified Registered Nurse Anesthetist	7397	NC

General Provider Information

NPI Number	:	1588253462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARRETT STEPHEN CASEY CRNA

Provider Business Mailing Address
First Line	:	601 E ERIE ST UNIT 314
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-6223
Country	:	US
Telephone Number	:	504-914-8118
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 N LAKE DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-4508
Country	:	US
Telephone Number	:	504-914-8118
Fax Number	:

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

Provider Enumeration Date	:	01/14/2021
Last Update Date	:	06/09/2026

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