Individual
TINA M CASSELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1001 6TH AVE, SUITE 300, LEAVENWORTH, KS 66048-3222
(913) 682-5588
(913) 682-2698
Mailing address
1001 6TH AVE, SUITE 300, LEAVENWORTH, KS 66048-3222
(913) 682-5588
(913) 682-2698
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44644
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100318140B
—
KS
Enumeration date
08/20/2006
Last updated
07/08/2007
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