Provider Demographics
NPI:1487954012
Name:PERSINGER, CASEY MARIE
Entity type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:MARIE
Last Name:PERSINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:MARIE
Other - Last Name:KNOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 BRENT LN UNIT 101
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2240
Mailing Address - Country:US
Mailing Address - Phone:850-631-2106
Mailing Address - Fax:
Practice Address - Street 1:33 BRENT LN UNIT 101
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2240
Practice Address - Country:US
Practice Address - Phone:850-631-2106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03124429183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist