Provider Demographics
NPI:1154313138
Name:CASEY, ELISA HANSON (ARNP)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:HANSON
Last Name:CASEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ELISA
Other - Middle Name:BETH
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1965 CAPITAL CIR NE STE 200
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-8402
Mailing Address - Country:US
Mailing Address - Phone:850-656-2006
Mailing Address - Fax:850-656-2820
Practice Address - Street 1:1965 CAPITAL CIR NE STE 200
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-8402
Practice Address - Country:US
Practice Address - Phone:850-656-2006
Practice Address - Fax:850-656-2820
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2749512363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307174000Medicaid
FLY082JOtherBCBS OF FLORIDA
FLQ46206Medicare UPIN
FLU4982AMedicare PIN