Provider Demographics
NPI:1881900959
Name:DYE, CASEY (LPN)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:DYE
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 1:410 CRANBERRY ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1067
Mailing Address - Country:US
Mailing Address - Phone:814-455-7827
Mailing Address - Fax:814-455-7831
Practice Address - Street 1:410 CRANBERRY ST
Practice Address - Street 2:SUITE 210
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1067
Practice Address - Country:US
Practice Address - Phone:814-455-7827
Practice Address - Fax:814-455-7831
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN276535164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA29450280OtherPA DRIVER'S LINCENSE