Provider Demographics
NPI:1538438239
Name:RAMIREZ, CASIE MICHELLE (PA-C)
Entity type:Individual
Prefix:
First Name:CASIE
Middle Name:MICHELLE
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CASIE
Other - Middle Name:MICHELLE
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:393 WALLACE RD
Mailing Address - Street 2:SUITE A202
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4880
Mailing Address - Country:US
Mailing Address - Phone:615-832-2200
Mailing Address - Fax:615-832-2020
Practice Address - Street 1:353 NEW SHACKLE ISLAND RD STE 128B
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2329
Practice Address - Country:US
Practice Address - Phone:615-822-8908
Practice Address - Fax:615-822-8909
Is Sole Proprietor?:No
Enumeration Date:2011-12-26
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
TNPA3019363AM0700X
363AS0400X
TN3019363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ025602Medicaid