Provider Demographics
NPI:1487373254
Name:HESTER, CASEY (PMHMP)
Entity type:Individual
Prefix:MR
First Name:CASEY
Middle Name:
Last Name:HESTER
Suffix:
Gender:M
Credentials:PMHMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 PEBBLE CREEK LOOP
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-1810
Mailing Address - Country:US
Mailing Address - Phone:662-801-8062
Mailing Address - Fax:
Practice Address - Street 1:405 GALLERIA DR STE E
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4717
Practice Address - Country:US
Practice Address - Phone:662-640-4004
Practice Address - Fax:662-238-4122
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905501363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health