Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN276837 | GA |
N | 363LA2100X | Nurse Practitioner - Acute Care | 20223 | TN |
N | 363LA2100X | Nurse Practitioner - Acute Care | 5007870 | NC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 20223 | TN |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 281623 | NC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 5007870 | NC |
NPI | 1003291378 |
---|---|
Provider Name | Jason R Casey |
First Address | Snellville, GA 30078-5686 |
Second Address | Snellville, GA 30078-5686 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2015 |
Last Update Date | 28/01/2019 |