Provider Demographics
NPI:1447400189
Name:CASEY, LINDA M (LM)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:CASEY
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:LINDY
Other - Middle Name:
Other - Last Name:CASEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPM
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:SHELL LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54871-0013
Mailing Address - Country:US
Mailing Address - Phone:715-645-0392
Mailing Address - Fax:715-468-7855
Practice Address - Street 1:210 8TH AVENUE
Practice Address - Street 2:
Practice Address - City:SHELL LAKE
Practice Address - State:WI
Practice Address - Zip Code:54871
Practice Address - Country:US
Practice Address - Phone:715-645-0392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI35-049176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife