Provider Demographics
NPI:1639855604
Name:KICHLER, CASIE (APRN)
Entity Type:Individual
Prefix:
First Name:CASIE
Middle Name:
Last Name:KICHLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CASIE
Other - Middle Name:
Other - Last Name:MCCAFFERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10720 EAGLE RIDGE PLACE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223
Mailing Address - Country:US
Mailing Address - Phone:312-835-9289
Mailing Address - Fax:
Practice Address - Street 1:10720 EAGLE RIDGE PLACE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223
Practice Address - Country:US
Practice Address - Phone:312-835-9289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011799364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health