Provider Demographics
NPI:1417476813
Name:GILL, KASSIE MARIE (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:KASSIE
Middle Name:MARIE
Last Name:GILL
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 DEMANDRE ST
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-2341
Mailing Address - Country:US
Mailing Address - Phone:828-778-4803
Mailing Address - Fax:
Practice Address - Street 1:148 WALL BLVD
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7107
Practice Address - Country:US
Practice Address - Phone:504-393-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09607363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner