Provider Demographics
NPI:1477919066
Name:CASSEL, CECILY CATHERINE (PA-C)
Entity Type:Individual
Prefix:
First Name:CECILY
Middle Name:CATHERINE
Last Name:CASSEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CECILY
Other - Middle Name:CATHERINE
Other - Last Name:ROLLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 S PARK ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1375
Practice Address - Country:US
Practice Address - Phone:608-287-2100
Practice Address - Fax:608-287-2324
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3650363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical