Provider Demographics
NPI:1023416740
Name:CASEY, RENEE (NP)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:
Last Name:CASEY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:5410 MARYLAND WAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5064
Mailing Address - Country:US
Mailing Address - Phone:615-577-6352
Mailing Address - Fax:615-810-8969
Practice Address - Street 1:400 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-1025
Practice Address - Country:US
Practice Address - Phone:585-786-2233
Practice Address - Fax:585-786-1232
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2024-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY307072363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400196353Medicare PIN