Individual
MR. CASEY EUGENE BALDWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202
(502) 562-3000
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0330
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1138522
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300016528
—
IN
01
—
3012401
LICENSE
KY
05
—
7100550440
—
KY
01
—
K260160
MEDICARE
KY
Enumeration date
06/11/2018
Last updated
09/18/2018
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