Provider Demographics
NPI:1205066917
Name:KASSEL, EMILY BRAY (ARNP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:BRAY
Last Name:KASSEL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:F
Other - Last Name:BRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:4114 SUNBEAM RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-8847
Mailing Address - Country:US
Mailing Address - Phone:904-738-6767
Mailing Address - Fax:904-407-8131
Practice Address - Street 1:4266 SUNBEAM RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-2425
Practice Address - Country:US
Practice Address - Phone:904-407-7710
Practice Address - Fax:904-407-8131
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9230810363LA2200X
FLARNP9230810363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY03Q0OtherBCBSFL
FL001357300Medicaid
FL001357300Medicaid
FLP00804780Medicare PIN