Provider Demographics
NPI:1306996137
Name:CASEY, HEIDI HEATHER (RN)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:HEATHER
Last Name:CASEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 BRADSHAW WOODS DR
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-9302
Mailing Address - Country:US
Mailing Address - Phone:423-735-0261
Mailing Address - Fax:
Practice Address - Street 1:101 OKOLONA DR
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1387
Practice Address - Country:US
Practice Address - Phone:423-743-9103
Practice Address - Fax:423-743-9105
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000127038163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health