Individual
MS. KELLIE ANN KASPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
403 BETHEL RD, SOMERS POINT, NJ 08244-2108
(609) 927-8746
(609) 653-8807
Mailing address
403 BETHEL RD, SOMERS POINT, NJ 08244-2108
(609) 927-8746
(609) 601-1406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00566600
NJ MEDICAL LICENSE
NJ
Enumeration date
06/30/2020
Last updated
08/20/2020
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