MEDICARE: CASIE JO LAHR FNP-C

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	207Q00000X	Family Medicine Physician	71015204A	IN

General Provider Information

NPI Number	:	1982450391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASIE JO LAHR FNP-C

Provider Business Mailing Address
First Line	:	272 SUBURBAN ST
Second Line	:
City	:	DANVILLE
State	:	IN
Zip	:	46122-8011
Country	:	US
Telephone Number	:	812-249-4072
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 N MERIDIAN ST STE 700
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-1236
Country	:	US
Telephone Number	:	317-962-0800
Fax Number	:

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

Provider Enumeration Date	:	04/26/2024
Last Update Date	:	04/26/2024

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