Provider Demographics
NPI:1801175930
Name:CASTER, KAMEA (LPN)
Entity type:Individual
Prefix:
First Name:KAMEA
Middle Name:
Last Name:CASTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 CANANDAIGUA RD
Mailing Address - Street 2:P.O. BOX 151
Mailing Address - City:PALMYRA
Mailing Address - State:NY
Mailing Address - Zip Code:14522-9701
Mailing Address - Country:US
Mailing Address - Phone:315-576-2309
Mailing Address - Fax:
Practice Address - Street 1:885 CANANDAIGUA RD
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:NY
Practice Address - Zip Code:14522-9701
Practice Address - Country:US
Practice Address - Phone:315-576-2309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-07
Last Update Date:2011-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280855164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse