Provider Demographics
NPI:1609318427
Name:BRUSHABER, CASEY (RN)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:BRUSHABER
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 1:1564 BRADMORE DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-2013
Mailing Address - Country:US
Mailing Address - Phone:419-360-8980
Mailing Address - Fax:
Practice Address - Street 1:2109 HUGHES DR
Practice Address - Street 2:SUITE 640
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3856
Practice Address - Country:US
Practice Address - Phone:567-661-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.424392163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse