Provider Demographics
NPI:1275774051
Name:SASSER, CASEY WILLIAM (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:CASEY
Middle Name:WILLIAM
Last Name:SASSER
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 THOMPSON LN STE 30330
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-4701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3443 DICKERSON PIKE STE 680
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2537
Practice Address - Country:US
Practice Address - Phone:615-865-3322
Practice Address - Fax:615-467-6692
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14020208M00000X
TNAPN0000014020363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1516161Medicaid
TN1031503827Medicare PIN