=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407765761
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GEORGIA MAE CASON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/03/2026
-----------------------------------------------------
Last Update Date | 09/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3600 30TH ST
-----------------------------------------------------
City | DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50310-5753
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-699-5771
-----------------------------------------------------
Fax | 515-699-5727
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5525 SE 24TH ST
-----------------------------------------------------
City | DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50320-2735
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-699-5771
-----------------------------------------------------
Fax | 515-699-5727
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 111101
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------