Healthcare Provider Details

I. General information

NPI: 1851366447
Provider Name (Legal Business Name): DOROTHEA MARGARET CASE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 06/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 LUDINGTON ST
ESCANABA MI
49829-1300
US

IV. Provider business mailing address

3433 34TH AVE S
MINNEAPOLIS MN
55406-2730
US

V. Phone/Fax

Practice location:
  • Phone: 906-786-3311
  • Fax:
Mailing address:
  • Phone: 920-288-2116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR-108339-8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: