Healthcare Provider Details

I. General information

NPI: 1871306134
Provider Name (Legal Business Name): CASEY C ANDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11004 BANDLYTOWN PL
BELLEVUE NE
68123-1043
US

IV. Provider business mailing address

2004 YORKTOWN ST
BELLEVUE NE
68123-5059
US

V. Phone/Fax

Practice location:
  • Phone: 785-466-1723
  • Fax:
Mailing address:
  • Phone: 785-466-1723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: