Provider Demographics
NPI:1104825116
Name:CASEY, JOE VERNON JR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:VERNON
Last Name:CASEY
Suffix:JR
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:601 W MAPLE AVE STE 503
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-5376
Mailing Address - Country:US
Mailing Address - Phone:479-751-3722
Mailing Address - Fax:479-751-1099
Practice Address - Street 1:609 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-5335
Practice Address - Country:US
Practice Address - Phone:479-751-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2022-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OKR0083727367500000X
TXAP128983367500000X
CA596812367500000X
OHAPRN.CRNA.17071367500000X
ARC003278367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered