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1962023200
CASEY WILDER
GALLUP, NM
NPI
1962023200
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Former Name
CASEY SULLIVAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163WE0003X Registered Nurse, Emergency
(Licence: TX 930837)
Enumeration Date
2020-04-28
Last Update Date
2020-04-28
Business Address
CASEY WILDER RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
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Mailing Address
CASEY WILDER RN
507 FARLEY ST
WAXAHACHIE, TX 75165-2752
Phone number: 214-632-4061
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