| Doctor Name: | BEVERLY KAY CASSELLIUS |
| NPI Number: | 1073759387 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BSN |
| License Number: | 108061-030 |
| Business Practice Address: | 307 W Warren St Tomah, WI - 546601399 |
| Business Phone Number: | 6083723012 |
| Business Fax Number: | 6087855330 |
| Mailing Address: | 21767 State Highway 16, TOMAH |
| State: | WI |
| Postal Code: | 546606822 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/17/2008 |
| NPI Last Update Date: | 12/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 108061-030 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |