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General NPI Number Information
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NPI Number | 1609109230
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Entity Type | Individual
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Provider Name | SANDY STEWART CASEY CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/15/2009
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 1370 W D ST
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-3586
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Country | US
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Telephone | 336-651-8523
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Fax | 336-651-8531
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Provider Business Mailing Address
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Address Line | 1370 W D ST
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-3586
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Country | US
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Telephone | 336-651-8523
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Fax | 336-651-8531
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 219614
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License Number State | NC
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