Provider Demographics
NPI:1578132122
Name:ALFREY, KASEY CHRISTINA (LPN)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:CHRISTINA
Last Name:ALFREY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 N RILEY HWY
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-9465
Mailing Address - Country:US
Mailing Address - Phone:317-398-8422
Mailing Address - Fax:
Practice Address - Street 1:2200 N RILEY HWY
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-9465
Practice Address - Country:US
Practice Address - Phone:317-398-8422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27072689A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse