Individual
MARISSA DAYLE CASBOHM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2555 COURT DR STE 450, GASTONIA, NC 28054-2191
(814) 000-0000
Mailing address
2555 COURT DR STE 450, GASTONIA, NC 28054-2191
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP025022
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/08/2021
Last updated
02/20/2024
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