Provider Demographics
NPI:1053943266
Name:CASEY, MEGHAN LAREE (PA-C)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LAREE
Last Name:CASEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2248
Mailing Address - Country:US
Mailing Address - Phone:402-646-4622
Mailing Address - Fax:402-646-4635
Practice Address - Street 1:250 N COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2248
Practice Address - Country:US
Practice Address - Phone:402-646-4622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2462363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant