Provider Demographics
NPI:1043828775
Name:BIELCASSARINO, SIERRA N (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SIERRA
Middle Name:N
Last Name:BIELCASSARINO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:SIERRA
Other - Middle Name:N
Other - Last Name:CORNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-998-4575
Mailing Address - Fax:419-998-4586
Practice Address - Street 1:1003 BELLEFONTAINE AVE STE 150
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-1871
Practice Address - Country:US
Practice Address - Phone:419-998-8295
Practice Address - Fax:419-226-8323
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006448RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant