Provider Demographics
NPI:1083965024
Name:MICHAELSEN, CARA E (PA-C)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:E
Last Name:MICHAELSEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:600 CROSS POINTE RD STE A
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6696
Mailing Address - Country:US
Mailing Address - Phone:513-725-2186
Mailing Address - Fax:614-577-1427
Practice Address - Street 1:2443 SIR BARTON WAY STE 275
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2707
Practice Address - Country:US
Practice Address - Phone:859-523-1776
Practice Address - Fax:859-447-8287
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2018-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDC0004897363A00000X
NC0010-04801363A00000X
KYPA2239363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant