Individual
CHARISSA ELTON-LACASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3500 I-30 BOX, MESQUITE, TX 78185-1672
(972) 698-3300
Mailing address
843 YELLOW TAVERN CT, GRAND PRAIRIE, TX 75052-1648
(214) 686-8564
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
605266
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
605266
NURSE PRACTITIONERS
TX
Enumeration date
07/25/2006
Last updated
07/08/2007
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