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NPI Code Detail

MEDICARE: KYLIE CASEY FNP

MEDICARE: KYLIE CASEY FNP
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
1363LA2100XAcute Care Nurse PractitionerAP134283TX
2363LF0000XFamily Nurse PractitionerAP134283TX

General Provider Information

NPI Number : 1720509508
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLIE CASEY FNP
Provider Business Mailing Address
First Line : 903 W MARTIN ST # MS 49-2
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78207-0903
Country : US
Telephone Number : 210-358-0572
Fax Number : 210-358-5940
Provider Business Practice Location Address
First Line : 4502 MEDICAL DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-4402
Country : US
Telephone Number : 210-358-4000
Fax Number : 210-358-4775
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2017
Last Update Date : 12/01/2025

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