Casey At Dively, NP-C
NPI #1386171809 in Taylorville, Illinois
Provider Information
- NPI Number
- 1386171809
- Entity Type
- Individual
- Name
- Casey At Dively, NP-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Family
- Credential
- NP-C
- Enumeration Date
- May 15, 2017
- Last Updated
- Jan 13, 2025
Practice Location
- Address
- 1304 BURNETT DR
- City
- Taylorville
- State
- Illinois
- ZIP Code
- 62568-9519
- Phone
- (217) 321-9310
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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