Provider Demographics
NPI:1124560453
Name:CASWELL, KATIE ANNE (LPN)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ANNE
Last Name:CASWELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WOODALE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-4403
Mailing Address - Country:US
Mailing Address - Phone:585-993-6119
Mailing Address - Fax:
Practice Address - Street 1:43 WOODALE DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-4403
Practice Address - Country:US
Practice Address - Phone:585-993-6119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316571164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse