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General NPI Number Information
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NPI Number | 1578954533
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Entity Type | Individual
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Provider Name | JENNIFER HARDY CASELLA NP
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Gender | Female
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 950 15TH ST
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City | AUGUSTA
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State | GA
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Zip | 30901-2608
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Country | US
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Telephone | 706-733-0188
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Fax | 706-823-3983
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Provider Business Mailing Address
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Address Line | 950 15TH ST
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City | AUGUSTA
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State | GA
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Zip | 30901-2608
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Country | US
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Telephone | 706-733-0188
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Fax | 706-823-3983
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN183834
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN183834
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN183834
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | RN183834
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License Number State | GA
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