Provider Demographics
NPI:1033871439
Name:TRAMEL, CASEY (FNP)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:TRAMEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 COUNTY ROAD 389
Mailing Address - Street 2:
Mailing Address - City:WATER VALLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38965-3863
Mailing Address - Country:US
Mailing Address - Phone:662-832-5270
Mailing Address - Fax:
Practice Address - Street 1:1250 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-2456
Practice Address - Country:US
Practice Address - Phone:662-298-2238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily