Provider Demographics
NPI:1982941183
Name:WODZIEN, CASIE L (APRN)
Entity Type:Individual
Prefix:
First Name:CASIE
Middle Name:L
Last Name:WODZIEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14919 BOWFIN TER
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5822
Mailing Address - Country:US
Mailing Address - Phone:608-215-8134
Mailing Address - Fax:
Practice Address - Street 1:8340 LAKEWOOD RANCH BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5183
Practice Address - Country:US
Practice Address - Phone:608-215-8134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5173-33363L00000X
FLARNP9492729363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI61390OtherDEAN HEALTH INSURANCE
WI61390OtherDEAN HEALTH INSURANCE