Basic Information
| Provider Information | |||||||||
| NPI: | 1952379497 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASEY | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | CATHERINE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2550 UNIVERSITY AVE W STE 110N | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551142001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6516025309 | ||||||||
| FaxNumber: | 6512226786 | ||||||||
| Practice Location | |||||||||
| Address1: | 6545 FRANCE AVE S STE 210 | ||||||||
| Address2: | |||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554352281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529282900 | ||||||||
| FaxNumber: | 9529282944 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 11/29/2017 | ||||||||
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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 | 207VG0400X | 48116 | MN | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 207VX0201X | 48116 | MN | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology |
ID Information
| ID | Type | State | Issuer | Description | 438968900 | 05 | MN | MEDICAID | 423G5CA | 01 | MN | BLUE CROSS BLUE SHIELD MN | OTHER | 2388740 | 01 | MN | AMERICA'S PPO | OTHER | 34705500 | 05 | WI | MEDICAID | 1044757 | 01 | MN | PREFERREDONE | OTHER | HP56427 | 01 | MN | HEALTHPARTNERS | OTHER | 0704582 | 01 | MN | MEDICA | OTHER |