Provider Demographics
NPI:1831760008
Name:LANUS, CASEY PAYNE (FNP-C)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:PAYNE
Last Name:LANUS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:MICHELLE
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:8839 BLACK BIRCH AVE
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-8352
Mailing Address - Country:US
Mailing Address - Phone:225-278-5111
Mailing Address - Fax:
Practice Address - Street 1:8839 BLACK BIRCH AVE
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-8352
Practice Address - Country:US
Practice Address - Phone:225-278-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA203934363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily