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NPI Code Detail

MEDICARE: LYNNETTE CASEY CNM

MEDICARE:   LYNNETTE  CASEY  CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice MidwifeRN110106AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN110106OTHERAZRN

General Provider Information

NPI Number : 1124135751
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNNETTE CASEY CNM
Provider Business Mailing Address
First Line : 3660 W BETHANY HOME RD
Second Line : SUITE A
City : PHOENIX
State : AZ
Zip : 85019-1953
Country : US
Telephone Number : 602-973-3200
Fax Number : 602-795-3714
Provider Business Practice Location Address
First Line : 3660 W BETHANY HOME RD
Second Line : SUITE A
City : PHOENIX
State : AZ
Zip : 85019-1953
Country : US
Telephone Number : 602-973-3200
Fax Number : 602-795-3714
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 09/04/2013

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