Provider Demographics
NPI:1306393673
Name:VALE, CASEY (RN)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:VALE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:JORDAN
Other - Last Name:BRYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2125 17TH ST S
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-6736
Mailing Address - Country:US
Mailing Address - Phone:608-780-1679
Mailing Address - Fax:
Practice Address - Street 1:2125 17TH ST S
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-6736
Practice Address - Country:US
Practice Address - Phone:608-780-1679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-05
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22935230163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse