Provider Demographics
NPI:1669857587
Name:KASEL, KACEY ANN (RN)
Entity Type:Individual
Prefix:
First Name:KACEY
Middle Name:ANN
Last Name:KASEL
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 1:820 WINNEBAGO AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-3645
Mailing Address - Country:US
Mailing Address - Phone:507-235-5999
Mailing Address - Fax:507-235-8224
Practice Address - Street 1:820 WINNEBAGO AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-3645
Practice Address - Country:US
Practice Address - Phone:507-235-5999
Practice Address - Fax:507-235-8224
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR2241061-9163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management