Provider Demographics
NPI:1609109230
Name:CASEY, SANDY STEWART (CRNA)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:STEWART
Last Name:CASEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1370 W D ST
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-3586
Mailing Address - Country:US
Mailing Address - Phone:336-651-8523
Mailing Address - Fax:336-651-8531
Practice Address - Street 1:1370 W D ST
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3586
Practice Address - Country:US
Practice Address - Phone:336-651-8523
Practice Address - Fax:336-651-8531
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC219614367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered