Casey Banahan Baine, ACAGNP
Nurse Practitioner, Acute Care in Jackson, MS. Individual provider (NPI-1).
NPI number1245835263
StatusActive
Last updated in NPPESNov 28, 2023
Details
- NPI
- 1245835263
- Entity type
- Individual (NPI-1)
- Name
- Casey Banahan Baine
- Credential
- ACAGNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 30, 2020
- Certification date
- Nov 28, 2023
- Last updated
- Nov 28, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2100X | Nurse Practitioner, Acute Care | 904142 | MS | Yes |
Practice location
969 Lakeland DrJackson, MS 39216-4606
Phone 601-200-3631 · Fax 601-200-0159
Mailing address
5959 S Sherwood Forest BlvdBaton Rouge, LA 70816-6038
Phone 601-200-3631 · Fax 225-765-9196
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All 86 Acute Care Nurse Practitioner providers in Jackson · All 8,702 providers in Jackson
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