Provider Demographics
NPI:1033916648
Name:KAISER, CASEY JO (RN)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:JO
Last Name:KAISER
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:LOMIRA
Mailing Address - State:WI
Mailing Address - Zip Code:53048-9590
Mailing Address - Country:US
Mailing Address - Phone:262-309-2704
Mailing Address - Fax:
Practice Address - Street 1:8660 CULLEN LN
Practice Address - Street 2:
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-9009
Practice Address - Country:US
Practice Address - Phone:262-573-1321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI25219030163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice