Branham, Casey L
Branham, Casey L is an individual health care provider with primary practice located at 520 Mary St Ste 520 , Evansville IN 47710-1682. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Branham, Casey L can be contacted via phone (812) 424-8231.Contact Information
Primary practice address
520 Mary St Ste 520
Evansville IN 47710-1682
Phone: (812) 424-8231
Fax: (812) 435-8794
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 10003686 | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | Indiana |
Profile Details
| NPI number | 1508508748 |
|---|---|
| LBN Legal business name | Branham, Casey L |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2022 |
| Last updated | Mar 6th, 2024 - about 9 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508508748 | NPPES |
| Indiana | Other | 1198036 | NCCPA CERTIFICATION |
| Indiana | MEDICAID | 7100839460 | NCCPA CERTIFICATION |
| Indiana | MEDICAID | 300066142 | NCCPA CERTIFICATION |
| Indiana | Other | 1102629959 | NCCPA CERTIFICATION |
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