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Contact Information

CASEY B BAINE, ACAGNP
969 LAKELAND DR
JACKSON, MS39216-4606
 Phone: 601-200-3631
 Fax: 601-200-0159
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acute Care

363LA2100X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for CASEY B BAINE · (Female)

NPI # 1245835263
Status Active
Credentials ACAGNP
Entity Individual
Enumeration date 11/30/2020
Last updated 11/28/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 904142
Hospital affiliation(s)
  • ST DOMINIC-JACKSON MEMORIAL HOSPITAL - (Acute Care)
    969 LAKELAND DR
    JACKSON, MS 39216
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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