Ms. Carly Lynn Kassa
Nurse Practitioner - Gerontology
50 N Perry St
Pontiac
, Michigan 48342-2217
Ms. Carly Lynn Kassa
Nurse Practitioner - Gerontology
50 N Perry St
Pontiac
, Michigan 48342-2217
(248) 227-2897
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Ms. Carly Lynn Kassa
- 232 Grace Avuenue
- Rochester Hills, MI
- Zip : 48307
- Phone : (248) 227-2897
Second Address
- Ms. Carly Lynn Kassa
- 50 N Perry St
- Pontiac, MI
- Zip : 48342-2217
- Fax : (248) 338-5547
- Phone : (248) 338-5645
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 4704297338 | MI |
National Provider Identifier
| NPI | 1083106140 |
|---|---|
| Provider Name | Ms. Carly Lynn Kassa |
| First Address | Rochester Hills, MI 48307 |
| Second Address | Pontiac, MI 48342-2217 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/06/2018 |
| Last Update Date | 05/06/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.