MEDICARE: CAROL M CASH RN ACNP-BC CNN

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
1	363LA2100X	Acute Care Nurse Practitioner	512726	TX

General Provider Information

NPI Number	:	1396717542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL M CASH RN ACNP-BC CNN

Provider Business Mailing Address
First Line	:	2929 CALDER ST
Second Line	:	SUITE 100
City	:	BEAUMONT
State	:	TX
Zip	:	77702-1845
Country	:	US
Telephone Number	:	409-833-9797
Fax Number	:	409-654-6886

Provider Business Practice Location Address
First Line	:	3570 COLLEGE ST
Second Line	:	SUITE 200
City	:	BEAUMONT
State	:	TX
Zip	:	77701-4683
Country	:	US
Telephone Number	:	409-833-9797
Fax Number	:	409-654-6909

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	08/31/2015

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