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Provider Information for 1992366967

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MRS. JENNIFER CASOLA APRN

Gender: FEMALE

Individual NPI: 1992366967

Calendar   Last Updated:  2019-12-23
  Certification Date:  2019-12-23

Details

Name Value
NPI 1992366967
Enumeration Date 2019-06-21
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 2671 W NORVELL BRYANT HWY
LECANTO, FL 34461-9440
United States

Phone: 525-135-9063 | Fax: 352-513-4872
View Map External Link
Primary Practice Address 2671 W NORVELL BRYANT HWY
LECANTO, FL 34461-9440
United States

Phone: 352-513-5906 | Fax: 352-513-4872
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363L00000X - Nurse Practitioner FL 11002865