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General NPI Number Information
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NPI Number | 1669857587
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Entity Type | Individual
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Provider Name | KACEY ANN KASEL RN
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Gender | Female
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Dates
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Enumeration Date | 07/21/2015
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Last Update Date | 07/21/2015
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Provider Practice Location Address
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Address Line | 820 WINNEBAGO AVE SUITE 3
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City | FAIRMONT
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State | MN
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Zip | 56031-3645
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Country | US
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Telephone | 507-235-5999
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Fax | 507-235-8224
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Provider Business Mailing Address
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Address Line | 820 WINNEBAGO AVE SUITE 3
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City | FAIRMONT
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State | MN
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Zip | 56031-3645
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Country | US
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Telephone | 507-235-5999
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Fax | 507-235-8224
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | R2241061-9
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License Number State | MN
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