Provider Demographics
NPI:1962966317
Name:CASEL, KRISTINA GRACE (APRN)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:GRACE
Last Name:CASEL
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 N CENTRAL EXPY STE 230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4113
Mailing Address - Country:US
Mailing Address - Phone:702-533-0000
Mailing Address - Fax:
Practice Address - Street 1:10100 N CENTRAL EXPY STE 230
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4113
Practice Address - Country:US
Practice Address - Phone:702-533-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-29
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140371363LA2200X, 363LP0808X
NV826622363LA2200X
ID63364363LA2200X
VA0024182923363LA2200X
AZ251191363LA2200X
WAAP61591721363LA2200X, 363LP0808X
NY309494363LA2200X
OR10030035363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty