Provider Demographics
NPI:1497333801
Name:NOONAN, CASEY ANN (RN)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:ANN
Last Name:NOONAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ELKWAY
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3345
Mailing Address - Country:US
Mailing Address - Phone:617-365-7878
Mailing Address - Fax:
Practice Address - Street 1:12 ELKWAY
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3345
Practice Address - Country:US
Practice Address - Phone:617-365-7878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2339680163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health