Healthcare Provider Details

I. General information

NPI: 1669896783
Provider Name (Legal Business Name): JAMES DANIEL CASEY JR. CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 GOODMAN AVE
CINCINNATI OH
45224-1005
US

IV. Provider business mailing address

2000 16TH ST
DENVER CO
80202-5117
US

V. Phone/Fax

Practice location:
  • Phone: 720-631-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number15112
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number15112
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: