Healthcare Provider Details

I. General information

NPI: 1467006973
Provider Name (Legal Business Name): CASSEY JOLEEN LEMON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S MCGEE ST
BORGER TX
79007-4041
US

IV. Provider business mailing address

300 WHITNEY ST
BORGER TX
79007-7910
US

V. Phone/Fax

Practice location:
  • Phone: 806-274-5131
  • Fax:
Mailing address:
  • Phone: 806-640-7076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP141759
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: