MEDICARE: MRS. CHERYL ELIZABETH CASAMENTO APRN-BC

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	363LF0000X	Family Nurse Practitioner	TMP142899	KS
2	363LF0000X	Family Nurse Practitioner	53-75404-052	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417241993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL ELIZABETH CASAMENTO APRN-BC

Provider Business Mailing Address
First Line	:	1035 N. EMPORIA SUITE 105
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67214-2998
Country	:	US
Telephone Number	:	316-263-7285
Fax Number	:	316-263-2666

Provider Business Practice Location Address
First Line	:	1035 N. EMPORIA SUITE 105
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67214-2998
Country	:	US
Telephone Number	:	316-263-7285
Fax Number	:	316-263-2666

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

Provider Enumeration Date	:	06/02/2011
Last Update Date	:	02/15/2012

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Directions to “ MRS. CHERYL ELIZABETH CASAMENTO APRN-BC” Practice Location

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