Healthcare Provider Details

I. General information

NPI: 1558708644
Provider Name (Legal Business Name): CASEY PROFESSIONAL HEALTH SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E WILLIAMS AVE
FALLON NV
89406-3052
US

IV. Provider business mailing address

660 W WILLIAMS AVE
FALLON NV
89406-2739
US

V. Phone/Fax

Practice location:
  • Phone: 702-453-3799
  • Fax: 702-453-5741
Mailing address:
  • Phone: 702-453-3799
  • Fax: 775-423-1158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13278
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number13278
License Number StateNV

VIII. Authorized Official

Name: AMANDA SUE CASEY
Title or Position: OWNER
Credential: M.D.
Phone: 775-750-4408