Provider Demographics
NPI:1427450196
Name:LABIK, KACIE (PA-C)
Entity type:Individual
Prefix:
First Name:KACIE
Middle Name:
Last Name:LABIK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 MAIN ST STE 307
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-4478
Mailing Address - Country:US
Mailing Address - Phone:610-482-6500
Mailing Address - Fax:610-482-6501
Practice Address - Street 1:824 MAIN ST STE 307
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4478
Practice Address - Country:US
Practice Address - Phone:610-482-6500
Practice Address - Fax:610-482-6501
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA057112363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical