Provider Demographics
NPI:1972771780
Name:CASEY, CALLIE BLEVINS (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:BLEVINS
Last Name:CASEY
Suffix:
Gender:F
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 1:101 FORREST CROSSING BOULEVARD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064
Mailing Address - Country:US
Mailing Address - Phone:615-567-6726
Mailing Address - Fax:615-567-6729
Practice Address - Street 1:101 FORREST CROSSING BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5429
Practice Address - Country:US
Practice Address - Phone:615-567-6726
Practice Address - Fax:615-567-6729
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000145820163W00000X
TN0000013281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse