Provider Demographics
NPI:1023823606
Name:BRANDL, CASEY JO
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:JO
Last Name:BRANDL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVID CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68632-1467
Mailing Address - Country:US
Mailing Address - Phone:402-615-1631
Mailing Address - Fax:
Practice Address - Street 1:681 N 10TH ST
Practice Address - Street 2:
Practice Address - City:DAVID CITY
Practice Address - State:NE
Practice Address - Zip Code:68632-1467
Practice Address - Country:US
Practice Address - Phone:402-615-1631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker