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General NPI Number Information
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NPI Number | 1982433652
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Entity Type | Individual
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Provider Name | CASEY DOUGLAS AXMAN CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/30/2024
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Last Update Date | 05/24/2025
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Provider Practice Location Address
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Address Line | 200 E CHESTNUT ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-1800
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Country | US
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Telephone | 26-298-0005
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Fax |
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Provider Business Mailing Address
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Address Line | 6225 N STATE HIGHWAY 161 STE 200
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City | IRVING
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State | TX
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Zip | 75038-2241
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Country | US
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Telephone | 214-687-0001
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Fax | 972-518-2100
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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 | 4041128
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 20190043
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License Number State | KY
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