Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 50783 | MN |
NPI | 1386653699 |
---|---|
Provider Name | Dr. Colleen Louise Casey |
First Address | Lake Elmo, MN 55042-8478 |
Second Address | Minneapolis, MN 55407-1320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 30/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1011716 | (05) | VT |
E43158 | (02) | VT |