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General NPI Number Information
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NPI Number | 1205547486
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Entity Type | Individual
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Provider Name | CASEY JORDAN ACOSTA FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/08/2022
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 9039 SPRINGBORO PIKE STE C
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City | MIAMISBURG
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State | OH
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Zip | 45342-5442
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Country | US
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Telephone | 513-916-4128
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Fax | 877-728-4559
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Provider Business Mailing Address
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Address Line | 47 WOODED RIDGE DR
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City | AMELIA
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State | OH
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Zip | 45102-1795
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0032802
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0032802
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License Number State | OH
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