Provider Demographics
NPI:1669770244
Name:PARMAN, CASEY R (APN)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:R
Last Name:PARMAN
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64468-2655
Mailing Address - Country:US
Mailing Address - Phone:660-562-2600
Mailing Address - Fax:660-562-7994
Practice Address - Street 1:2016 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-2655
Practice Address - Country:US
Practice Address - Phone:660-562-2600
Practice Address - Fax:660-562-7994
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001018457163W00000X
MO2011004385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00944885OtherRR MEDICARE
MO1669770244Medicaid
KS200712710AMedicaid
MO701000086Medicare PIN