Healthcare Provider Details

I. General information

NPI: 1871569954
Provider Name (Legal Business Name): KRISTIN T CASEY NP RN MS CPNP CPON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 S 2ND ST
MOUNT HOREB WI
53572-3345
US

IV. Provider business mailing address

828 S 2ND ST
MOUNT HOREB WI
53572-3345
US

V. Phone/Fax

Practice location:
  • Phone: 608-575-3319
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2532
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: