Provider Demographics
NPI:1689484602
Name:CASAZZA, GINA MARIE (RN, BSN)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:CASAZZA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 KIRKBRIDE DR
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1584
Mailing Address - Country:US
Mailing Address - Phone:161-779-1762
Mailing Address - Fax:
Practice Address - Street 1:2215 KIRKBRIDE DR
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1584
Practice Address - Country:US
Practice Address - Phone:161-779-1762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2318227163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse