Individual
AMANDA MARIE KASSNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 746-0510
Mailing address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 743-5566
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5466-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100242585
—
WI
Enumeration date
03/10/2021
Last updated
04/03/2025
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