Provider Demographics
NPI:1417493768
Name:CASEY, SARAH ALYSE (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ALYSE
Last Name:CASEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32346 ARLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4218
Mailing Address - Country:US
Mailing Address - Phone:248-504-1459
Mailing Address - Fax:
Practice Address - Street 1:32346 ARLINGTON DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:MI
Practice Address - Zip Code:48025-4218
Practice Address - Country:US
Practice Address - Phone:248-504-1459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704265843163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse