Provider Demographics
NPI:1770238149
Name:CASEY, RUTH ANNE (BIT PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANNE
Last Name:CASEY
Suffix:
Gender:F
Credentials:BIT PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 W LAS COLINAS DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6864
Mailing Address - Country:US
Mailing Address - Phone:307-247-1571
Mailing Address - Fax:
Practice Address - Street 1:861 W LAS COLINAS DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-6864
Practice Address - Country:US
Practice Address - Phone:307-247-1571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator