KASSIDY JO TREACEY NPI 1003603481

NPI Information

  • NPI: 1003603481
  • Provider Name: KASSIDY JO TREACEY
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 505 N JACKSON ST
    JACKSON, MI
    ZIP 49201
  • Phone: (517) 748-5500

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NPI Details

Kassidy Jo Treacey is a family nurse practitioner in Jackson, MI with 1 years of experience. Kassidy Jo Treacey NPI is 1003603481. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

505 N JACKSON ST
JACKSON, MI
ZIP 49201-266
Phone: (517) 748-5500

The NPI 1003603481 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/21/2025 and was last updated on 4/21/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily4704352886MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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