Individual provider · Type 1 NPI

Casey Ryan Divin

Family Nurse Practitioner · San Antonio, TX

NPI number 1154835536 Active

Practice location

5414 Fredericksburg Rd Ste 100A
San Antonio, TX 78229-3641

Mailing address

20529 Wind Spgs
San Antonio, TX 78258-7457

Other practice locations

  • 20529 Wind Spgs, San Antonio, TX 78258-7457 · (210) 677-9697

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XAP135899 (TX)

Family Nurse Practitioner: Definition to come...

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About NPI 1154835536

Casey Ryan Divin's National Provider Identifier is 1154835536, issued on Nov 21, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in San Antonio, TX. The record was last updated on Jan 20, 2021.