Provider Demographics
NPI:1316609498
Name:JAMES, KAICY CHRISTNER (FNP-C)
Entity type:Individual
Prefix:
First Name:KAICY
Middle Name:CHRISTNER
Last Name:JAMES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S BLOOMINGTON ST STE 301
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135-2237
Mailing Address - Country:US
Mailing Address - Phone:888-862-9525
Mailing Address - Fax:833-638-0119
Practice Address - Street 1:1001 S BLOOMINGTON ST STE 301
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-2237
Practice Address - Country:US
Practice Address - Phone:888-862-9525
Practice Address - Fax:833-638-0119
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011678A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71011678AOtherAPRN PRESCRIPTIVE AUTHORITY LICENSE NUMBER