MEDICARE: JANE H CASSEL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	058	WY
2	363AM0700X	Medical Physician Assistant	PA.0007372	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124072616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE H CASSEL PA-C

Provider Business Mailing Address
First Line	:	1230 E 1ST ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2704
Country	:	US
Telephone Number	:	307-266-3174
Fax Number	:	307-261-6713

Provider Business Practice Location Address
First Line	:	2121 E HARMONY RD UNIT 300
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-3403
Country	:	US
Telephone Number	:	970-224-9102
Fax Number	:	970-224-9112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	04/14/2023

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Directions to “ JANE H CASSEL PA-C” Practice Location

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