Provider Demographics
NPI:1932417755
Name:JAMES, CASEY NICOLE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:NICOLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:NICOLE
Other - Last Name:THORNLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:209 INSTITUTIONAL DRIVE
Mailing Address - City:HOUTZDALE
Mailing Address - State:PA
Mailing Address - Zip Code:16698-1000
Mailing Address - Country:US
Mailing Address - Phone:814-378-1000
Mailing Address - Fax:814-378-8962
Practice Address - Street 1:209 INSTITUTIONAL DRIVE
Practice Address - Street 2:
Practice Address - City:HOUTZDALE
Practice Address - State:PA
Practice Address - Zip Code:16698-1000
Practice Address - Country:US
Practice Address - Phone:814-371-3980
Practice Address - Fax:814-371-8317
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054593363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical