Provider Demographics
NPI:1699286450
Name:BEUERLEIN, CASEY KATHLEEN (FNP)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:KATHLEEN
Last Name:BEUERLEIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:KATHLEEN
Other - Last Name:MCCLOSKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4140 W 190TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8767 WILSHIRE BLVD FL 2
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2714
Practice Address - Country:US
Practice Address - Phone:424-315-1211
Practice Address - Fax:424-315-1212
Is Sole Proprietor?:No
Enumeration Date:2017-10-19
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily