Provider Demographics
NPI:1356933428
Name:MESINA, ANASTACIA AUSTRIACO (PA-C)
Entity type:Individual
Prefix:MS
First Name:ANASTACIA
Middle Name:AUSTRIACO
Last Name:MESINA
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:7895 GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6665
Mailing Address - Country:US
Mailing Address - Phone:219-947-1910
Mailing Address - Fax:219-942-3829
Practice Address - Street 1:101 E 87TH AVE STE 420
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7335
Practice Address - Country:US
Practice Address - Phone:219-947-1910
Practice Address - Fax:219-769-2313
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN10003220A363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty