Provider Demographics
NPI:1982470589
Name:CASAS, BOBBI J (FNP)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:J
Last Name:CASAS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4659 TABOR CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28312-9663
Mailing Address - Country:US
Mailing Address - Phone:803-467-1728
Mailing Address - Fax:
Practice Address - Street 1:4659 TABOR CHURCH RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28312-9663
Practice Address - Country:US
Practice Address - Phone:803-467-1728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019540363LF0000X
TX1141236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily