MEDICARE: JANNA RAE CASEY FNP-C

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	1126419	TX
2	363LF0000X	Family Nurse Practitioner	26752	TN
3	363LF0000X	Family Nurse Practitioner	89894	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000000000	OTHER	TN	NONE

General Provider Information

NPI Number	:	1881238533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANNA RAE CASEY FNP-C

Provider Business Mailing Address
First Line	:	1804 HIGHWAY 45 BYP STE 604
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-4403
Country	:	US
Telephone Number	:	731-660-7971
Fax Number	:	731-660-8739

Provider Business Practice Location Address
First Line	:	201 JORDAN RD # 200
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-4495
Country	:	US
Telephone Number	:	931-703-1577
Fax Number	:	662-214-6057

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

Provider Enumeration Date	:	11/05/2019
Last Update Date	:	06/11/2026

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