Provider Demographics
NPI:1477883528
Name:CASSELL-HARRIS, ALISON MICHELLE (APRN-NP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:MICHELLE
Last Name:CASSELL-HARRIS
Suffix:
Gender:F
Credentials:APRN-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:908 DUPONT RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4602
Practice Address - Country:US
Practice Address - Phone:502-749-7909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006315363LP0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200991510Medicaid
KY7100104400Medicaid
KY00533210Medicare PIN
IN200991510Medicaid
KYK038491Medicare PIN
KY7100104400Medicaid
KY50022339OtherPASSPORT & PASSPORT ADVANTAGE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY
KY000000653428OtherANTHEM- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY
KY000052153FOtherHUMANA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY
KY7576389OtherCIGNA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY