Provider Demographics
NPI:1699401869
Name:CASSEUS, KESHA TORENTIA (NP)
Entity Type:Individual
Prefix:
First Name:KESHA
Middle Name:TORENTIA
Last Name:CASSEUS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S CANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-3806
Mailing Address - Country:US
Mailing Address - Phone:931-735-6630
Mailing Address - Fax:
Practice Address - Street 1:600 S CANNON BLVD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-3806
Practice Address - Country:US
Practice Address - Phone:317-356-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31834363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner