Provider Demographics
NPI:1972187607
Name:BUCHANAN, KASEY (RN)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 POINT NORTH PL
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2644
Mailing Address - Country:US
Mailing Address - Phone:706-272-4127
Mailing Address - Fax:706-279-3969
Practice Address - Street 1:302 POINT NORTH PL
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2644
Practice Address - Country:US
Practice Address - Phone:706-272-4127
Practice Address - Fax:706-279-3969
Is Sole Proprietor?:No
Enumeration Date:2021-05-09
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN247908163WE0003X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency