1275931867 NPI number — ADREANNE NASHEA CASON PA-C

Table of content: ADREANNE NASHEA CASON PA-C (NPI 1275931867)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275931867 NPI number — ADREANNE NASHEA CASON PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASON
Provider First Name:
ADREANNE
Provider Middle Name:
NASHEA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BAILEY
Provider Other First Name:
ADREANNE
Provider Other Middle Name:
NASHEA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1275931867
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1932 ALCOA HWY 360
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37920-1509
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-524-1869
Provider Business Mailing Address Fax Number:
865-544-6533

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1932 ALCOA HWY 360
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37920-1509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-524-1869
Provider Business Practice Location Address Fax Number:
865-544-6533
Provider Enumeration Date:
12/12/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363AS0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Q019288 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".