Provider Demographics
NPI:1396744322
Name:CASO, JENNIFER PATRICIA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:PATRICIA
Last Name:CASO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:PATRICIA
Other - Last Name:CORLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:220 BLALOCK DR
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-6245
Mailing Address - Country:US
Mailing Address - Phone:509-529-4466
Mailing Address - Fax:
Practice Address - Street 1:214 E BIRCH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3043
Practice Address - Country:US
Practice Address - Phone:509-522-0114
Practice Address - Fax:509-522-9868
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00134242163W00000X
WAAP30006682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily