MEDICARE: CASEY ALEXIS DYE APN

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	363L00000X	Nurse Practitioner	APN001059	NV

General Provider Information

NPI Number	:	1477790046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY ALEXIS DYE APN

Provider Business Mailing Address
First Line	:	6630 S MCCARRAN BLVD
Second Line	:	#4
City	:	RENO
State	:	NV
Zip	:	89509-6145
Country	:	US
Telephone Number	:	775-828-2873
Fax Number	:	775-828-2897

Provider Business Practice Location Address
First Line	:	6630 S MCCARRAN BLVD
Second Line	:	#4
City	:	RENO
State	:	NV
Zip	:	89509-6145
Country	:	US
Telephone Number	:	775-828-2873
Fax Number	:	775-828-2897

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

Provider Enumeration Date	:	01/19/2009
Last Update Date	:	10/12/2012

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