Provider Demographics
NPI:1629236708
Name:CASEY, JENNIFER THOMAS (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:THOMAS
Last Name:CASEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:ANDERSON
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:109 EAGLES NEST DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37148-2045
Mailing Address - Country:US
Mailing Address - Phone:615-799-1447
Mailing Address - Fax:615-799-6350
Practice Address - Street 1:2401 PARMAN PL
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1518
Practice Address - Country:US
Practice Address - Phone:615-799-1447
Practice Address - Fax:615-799-6350
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013415363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health