Provider Demographics
NPI:1235755000
Name:VILLHAUER, CASEY (PHARMD, BCGP)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:
Last Name:VILLHAUER
Suffix:
Gender:F
Credentials:PHARMD, BCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 NW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8710
Mailing Address - Country:US
Mailing Address - Phone:515-368-2704
Mailing Address - Fax:
Practice Address - Street 1:4105 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-8710
Practice Address - Country:US
Practice Address - Phone:515-368-2704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA205481835G0303X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric