KASEY LAX (NPI# 1346565629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346565629 |
| Entity Type | Individual |
| Full Name | KASEY LAX |
| Credential | ARNP |
| Practice Address |
622 W Market Street Bolivar TN 38008-2519 |
| Mailing Address |
Po Box 400 Jackson TN 38302-0400 |
| Practice Telephone | 7316582885 |
| Practice Fax Number | 7316582886 |
| Mailing Telephone | 7314255752 |
| Mailing Fax Number | 7314225743 |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2020-01-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 139704 | TN | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
14931 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
622 W MARKET STREET |
| City | BOLIVAR |
| State | TN |
| Zip Code | 38008-2519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194118588 | Anna Mcintyre | Nurse Practitioner | 622 W Market Street, Bolivar, TN 38008-2519 | 2015-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720639172 | Shanna Shackelford | Nurse Practitioner | 11100 Old Hwy 64 W, Bolivar, TN 38008 | 2019-09-26 |
| 1598326233 | Holly Brooke Shourd | Family Medicine | 1359 W Market St., Bolivar, TN 38008 | 2019-06-24 |
| 1992299234 | Angela Dawn Haynes | Registered Nurse | 10825 Hwy 64w, Bolivar, TN 38008 | 2018-06-20 |
| 1326595919 | Ashley Evon Jowers | Nurse Practitioner | 11100 Old Hwy 64 West, Bolivar, TN 38008 | 2016-09-01 |
| 1942458344 | Anita Pearl Johnson | Physical Therapy Assistant | 700 Knuckolls Ave, Bolivar, TN 38008 | 2008-08-28 |
| 1841340007 | State of Tennessee | Public Health or Welfare | 10825 Old Hwy 64, Bolivar, TN 38008 | 2007-01-11 |
| 1164479721 | Betty Ragon Lenoir | Physical Therapist | 789 Tennessee St, Bolivar, TN 38008 | 2006-05-28 |
| 1689623050 | County of Hardeman | Ambulance | 735 Naylor St, Bolivar, TN 38008 | 2006-05-10 |
| 1841287109 | Michiel Brent Rudder | Family Medicine | 622 West Market Street, Bolivar, TN 38008 | 2005-10-03 |
| 1982606497 | Richard Mast Reinhard IIi | Pediatrics | 629 Nuckolls Rd, Bolivar, TN 38008 | 2005-08-15 |
| Find all providers in zip 38008 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457803363 | Brandy Yarnell | Nurse Practitioner | 2520 S Springfield Ave, Bolivar, MO 65613-9691 | 2016-10-26 |
| 1144636119 | Gregary Byers | Nurse Practitioner | 107 Tennessee St, Bolivar, TN 38008-1822 | 2014-07-10 |
| 1780908228 | Miracle Healthcare LLC | Nurse Practitioner | 649b W Mcneal St, Bolivar, TN 38008-2519 | 2010-03-25 |
| 1538273396 | Marceleen K. Powell | Nurse Practitioner | 1120 S Springfield Ave, Bolivar, MO 65613-2512 | 2006-08-18 |
| 1023066057 | Tammi L Ferguson | Nurse Practitioner | 1700 W Market St, Suite J, Bolivar, TN 38008-1653 | 2006-05-04 |
| 1083679104 | Oma L Shelton | Nurse Practitioner | 2230 S Springfield Ave, Suite H-j, Bolivar, MO 65613-9133 | 2006-04-20 |
| 1750999231 | Bethany Martin | Nurse Practitioner | 1501 N Oakland Ave, Bolivar, MO 65613-3020 | 2020-07-21 |
| 1104474741 | Kaylee Jaynelle Ankrom | Nurse Practitioner | 1300 N Oakland Ave, Bolivar, MO 65613-3018 | 2019-08-27 |
| 1164074175 | Courtney Marie Brummel | Nurse Practitioner | 1120 S Springfield Ave, Bolivar, MO 65613-2512 | 2019-07-10 |
| 1194211664 | Olivia Jenae Cumley | Nurse Practitioner | 1240 N Butterfield Rd, Bolivar, MO 65613-3016 | 2018-07-07 |
| Find all providers in BOLIVAR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.