Provider Demographics
NPI:1184137747
Name:KASSIEN, MICHELE D (MSN, APRN)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:D
Last Name:KASSIEN
Suffix:
Gender:F
Credentials:MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 S QUEEN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3529
Mailing Address - Country:US
Mailing Address - Phone:302-736-1800
Mailing Address - Fax:302-734-2769
Practice Address - Street 1:737 S QUEEN ST STE 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3529
Practice Address - Country:US
Practice Address - Phone:302-736-1800
Practice Address - Fax:302-734-2769
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0001082363L00000X
DELG-0001082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner