Provider Demographics
NPI:1003101122
Name:MEYER, KASEY DENISE
Entity Type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:DENISE
Last Name:MEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KASEY
Other - Middle Name:DENISE
Other - Last Name:EMPIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2135 WOODBURN DR SE APT 2
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-4385
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2135 WOODBURN DR SE APT 2
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-4385
Practice Address - Country:US
Practice Address - Phone:616-272-4268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist