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NPI Code Detail

MEDICARE: MRS. KASEY DIANE LA CANNE FNP-C

MEDICARE: MRS. KASEY DIANE LA CANNE FNP-C
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
1363LF0000XFamily Nurse Practitioner705216TX

General Provider Information

NPI Number : 1801107396
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KASEY DIANE LA CANNE FNP-C
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7556 HONEYSUCKLE
Second Line :
City : TEMPLE
State : TX
Zip : 76502-5631
Country : US
Telephone Number : 254-742-7400
Fax Number : 254-742-7407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2010
Last Update Date : 09/29/2020

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