Provider Demographics
NPI:1861222473
Name:PERSINGER, CASEY MARIE
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:MARIE
Last Name:PERSINGER
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 1:190 S PORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43019-9378
Mailing Address - Country:US
Mailing Address - Phone:419-948-9873
Mailing Address - Fax:
Practice Address - Street 1:190 S PORTLAND ST
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:OH
Practice Address - Zip Code:43019-9378
Practice Address - Country:US
Practice Address - Phone:419-948-9873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty