Provider Demographics
NPI:1801170063
Name:POWER, KASIE N (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KASIE
Middle Name:N
Last Name:POWER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 W FOX RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5205
Mailing Address - Country:US
Mailing Address - Phone:765-717-5399
Mailing Address - Fax:765-216-6774
Practice Address - Street 1:3550 W FOX RIDGE LN
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5205
Practice Address - Country:US
Practice Address - Phone:765-717-5399
Practice Address - Fax:765-216-6774
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001324A363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical