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NPI Code Detail

MEDICARE: KASEY VANCE APRN

MEDICARE: KASEY VANCE APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner34808TN

General Provider Information

NPI Number : 1548124407
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASEY VANCE APRN
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 865-588-3173
Fax Number :
Provider Business Practice Location Address
First Line : 2112 N ROAN ST STE 300
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-2519
Country : US
Telephone Number : 423-202-7426
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 03/12/2026

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Directions to “ KASEY VANCE APRN” Practice Location

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