MEDICARE: TAMI JO CASARETO 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	163WH0200X	Home Health Registered Nurse	R 143219-8	MN

General Provider Information

NPI Number	:	1679899868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMI JO CASARETO RN

Provider Business Mailing Address
First Line	:	PO BOX 269
Second Line	:
City	:	INTERNATIONAL FALLS
State	:	MN
Zip	:	56649-0269
Country	:	US
Telephone Number	:	218-283-2488
Fax Number	:

Provider Business Practice Location Address
First Line	:	2206 CRABTREE BLVD
Second Line	:
City	:	INTERNATIONAL FALLS
State	:	MN
Zip	:	56649-2127
Country	:	US
Telephone Number	:	218-283-2488
Fax Number	:

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

Provider Enumeration Date	:	04/13/2010
Last Update Date	:	04/13/2010

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