Provider Demographics
NPI:1770020901
Name:CASEY, JAMIE RENE (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:RENE
Last Name:CASEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 NCTR RD
Mailing Address - Street 2:
Mailing Address - City:REDFIELD
Mailing Address - State:AR
Mailing Address - Zip Code:72132-9399
Mailing Address - Country:US
Mailing Address - Phone:870-718-0338
Mailing Address - Fax:
Practice Address - Street 1:2902 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4806
Practice Address - Country:US
Practice Address - Phone:501-268-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant