Basic Information
| Provider Information | |||||||||
| NPI: | 1245543990 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KASTNING | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4851 E PICKARD ST | ||||||||
| Address2: | |||||||||
| City: | MT PLEASANT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897751610 | ||||||||
| FaxNumber: | 9897751640 | ||||||||
| Practice Location | |||||||||
| Address1: | 4851 E PICKARD ST | ||||||||
| Address2: | |||||||||
| City: | MT PLEASANT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488582078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897751610 | ||||||||
| FaxNumber: | 9897751640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2010 | ||||||||
| LastUpdateDate: | 11/15/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 0153700430 | 01 | MI | BLUE CROSS BLUE SHIELD | OTHER | 0153700430 | 01 | MI | PA LICENSE | OTHER |