Provider Demographics
NPI:1073155131
Name:EICHLER, CASSANDRA DAWN (PA)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:DAWN
Last Name:EICHLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:DAWN
Other - Last Name:BENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:13450 N MERIDIAN ST STE 135
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1473
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13450 N MERIDIAN ST STE 135
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1473
Practice Address - Country:US
Practice Address - Phone:317-582-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006131RX363A00000X
IN10002966A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300039260Medicaid