Provider Demographics
NPI:1770235855
Name:AL HELOU, KASARA ANGELINA (PA)
Entity Type:Individual
Prefix:MRS
First Name:KASARA
Middle Name:ANGELINA
Last Name:AL HELOU
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:7130 HODGSON MEMORIAL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1527
Mailing Address - Country:US
Mailing Address - Phone:912-988-3181
Mailing Address - Fax:
Practice Address - Street 1:7130 HODGSON MEMORIAL DR STE 101
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1527
Practice Address - Country:US
Practice Address - Phone:912-355-3881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC4312363A00000X
GA10846363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant