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NPI Code Detail

MEDICARE: KASEY JAMES PMHNP

MEDICARE:   KASEY  JAMES  PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner303966AZ

General Provider Information

NPI Number : 1023862257
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASEY JAMES PMHNP
Provider Business Mailing Address
First Line : 3300 N TRIUMPH BLVD STE 500
Second Line :
City : LEHI
State : UT
Zip : 84043-6475
Country : US
Telephone Number : 801-821-2613
Fax Number :
Provider Business Practice Location Address
First Line : 1860 N 95TH LN STE 300
Second Line :
City : PHOENIX
State : AZ
Zip : 85037-5074
Country : US
Telephone Number : 480-626-7584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2024
Last Update Date : 04/15/2024

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