Humphries, Casey L

Humphries, Casey L is an individual health care provider with primary practice located at 4800 E Johnson Ave , Jonesboro AR 72405-8413. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Humphries, Casey L can be contacted via phone (662) 377-4394.

Contact Information

Primary practice address
4800 E Johnson Ave Jonesboro AR 72405-8413
Phone: (662) 377-4394
Fax: (662) 377-7045
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X A810167 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X C001250 Arkansas

Profile Details

NPI number 1265458459
LBN Legal business name Humphries, Casey L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Sep 8th, 2022 - about 4 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265458459 NPPES
Mississippi MEDICAID 01159742
Mississippi Other 009936767

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