Provider Demographics
NPI:1154330397
Name:CASSEL, CAROLIN A (FNP)
Entity Type:Individual
Prefix:
First Name:CAROLIN
Middle Name:A
Last Name:CASSEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 N 29TH
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0219
Mailing Address - Country:US
Mailing Address - Phone:406-252-5658
Mailing Address - Fax:406-252-4641
Practice Address - Street 1:1245 N 29TH
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0219
Practice Address - Country:US
Practice Address - Phone:406-252-5658
Practice Address - Fax:406-252-4641
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-14157363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000374350OtherBCBS
MT4303550Medicaid
MT000374350OtherBCBS
MT4303550Medicaid