Basic Information
| Provider Information | |||||||||
| NPI: | 1740426568 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | COULTER | ||||||||
| FirstName: | CASIE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2301 25TH ST S STE K | ||||||||
| Address2: | PLAINS ANESTHESIA PLLC | ||||||||
| City: | FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 58103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012341728 | ||||||||
| FaxNumber: | 7012341681 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 25TH ST S STE K | ||||||||
| Address2: | PLAINS ANESTHESIA PLLC | ||||||||
| City: | FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 581036104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012341728 | ||||||||
| FaxNumber: | 7012341681 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | R31161 | ND | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.