Healthcare Provider Details

I. General information

NPI: 1952082323
Provider Name (Legal Business Name): KASSANDRA VALERIE KASPER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2280 IVY RD
CHARLOTTESVILLE VA
22903-4977
US

IV. Provider business mailing address

2280 IVY RD
CHARLOTTESVILLE VA
22903-4977
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-2663
  • Fax:
Mailing address:
  • Phone: 434-924-2663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110010735
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-13407
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: