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NPI Code Detail

MEDICARE: KATHRYN THERESE KASSIN PA

MEDICARE: KATHRYN THERESE KASSIN PA
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
1363A00000XPhysician Assistant0708SD

General Provider Information

NPI Number : 1356589030
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN THERESE KASSIN PA
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number : 605-328-6585
Fax Number :
Provider Business Practice Location Address
First Line : 20 S PLUM ST
Second Line :
City : VERMILLION
State : SD
Zip : 57069-3346
Country : US
Telephone Number : 605-677-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2009
Last Update Date : 02/03/2026

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