Healthcare Provider Details

I. General information

NPI: 1285463349
Provider Name (Legal Business Name): KASSIE NOEL DAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 LAKEVIEW PKWY STE 130
ROWLETT TX
75088-9324
US

IV. Provider business mailing address

7501 LAKEVIEW PKWY STE 130
ROWLETT TX
75088-9324
US

V. Phone/Fax

Practice location:
  • Phone: 972-463-3100
  • Fax: 214-501-1303
Mailing address:
  • Phone: 972-463-3100
  • Fax: 214-501-1303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1178399
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number773319
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: