Healthcare Provider Details

I. General information

NPI: 1154834166
Provider Name (Legal Business Name): CASEY L LANE RN, MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASEY L WESTERMAN

II. Dates (important events)

Enumeration Date: 11/13/2017
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 E BATTLEFIELD ST
SPRINGFIELD MO
65804-3981
US

IV. Provider business mailing address

2715 E BATTLEFIELD ST
SPRINGFIELD MO
65804-3981
US

V. Phone/Fax

Practice location:
  • Phone: 417-888-0298
  • Fax:
Mailing address:
  • Phone: 417-888-0298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017034127
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: