MEDICARE: CASIE CLOSE RN

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
1	164W00000X	Licensed Practical Nurse	LPN.163065.MEDS-IV	OH
2	164W00000X	Licensed Practical Nurse	163065	OH

General Provider Information

NPI Number	:	1457837890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASIE CLOSE RN

Provider Business Mailing Address
First Line	:	1944 ALLEN RD
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-1038
Country	:	US
Telephone Number	:	330-831-3218
Fax Number	:

Provider Business Practice Location Address
First Line	:	1944 ALLEN RD
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-1038
Country	:	US
Telephone Number	:	330-831-3218
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2018
Last Update Date	:	04/15/2026

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Directions to “ CASIE CLOSE RN” Practice Location

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