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General NPI Number Information
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NPI Number | 1568864296
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Entity Type | Individual
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Provider Name | JAMIE LYNN CASSANI APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 10/07/2019
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Provider Practice Location Address
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Address Line | 14400 CLAYTON RD
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City | BALLWIN
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State | MO
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Zip | 63011-2713
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Country | US
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Telephone | 636-272-5856
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Fax |
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Provider Business Mailing Address
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Address Line | 2 GREENBANK DR
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City | CHESTERFIELD
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State | MO
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Zip | 63005-7105
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Country | US
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Telephone | 314-757-7794
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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 | 2014034216
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License Number State | MO
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