Provider Demographics
NPI:1598778250
Name:CASEY, KAREN SUE
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUE
Last Name:CASEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:BITTIKOFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1046 DORCHESTER RD.
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-1145
Mailing Address - Country:US
Mailing Address - Phone:937-335-0776
Mailing Address - Fax:937-335-0776
Practice Address - Street 1:1067 DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1145
Practice Address - Country:US
Practice Address - Phone:937-335-0776
Practice Address - Fax:937-335-0776
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2262153Medicaid