Provider Demographics
NPI:1063993145
Name:YENTES, KASEY JANEL (RN)
Entity type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:JANEL
Last Name:YENTES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:JANEL
Other - Last Name:BURGESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1669 HCR 3220
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76645-4091
Mailing Address - Country:US
Mailing Address - Phone:817-721-3698
Mailing Address - Fax:
Practice Address - Street 1:1669 HCR 3220
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-4091
Practice Address - Country:US
Practice Address - Phone:817-721-3698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218784164X00000X
TX1038917163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse