Provider Demographics
NPI:1639855604
Name:KICHLER, CASIE (APRN)
Entity type:Individual
Prefix:
First Name:CASIE
Middle Name:
Last Name:KICHLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CASIE
Other - Middle Name:
Other - Last Name:MCCAFFERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:850 S 28TH ST STE 102
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40211-1223
Practice Address - Country:US
Practice Address - Phone:502-632-8300
Practice Address - Fax:502-632-8635
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011799364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist