MS. CARLY LYNN KASSA NPI 1083106140

NPI Information

  • NPI: 1083106140
  • Provider Name: MS. CARLY LYNN KASSA
  • Classification: Nurse Practitioner - 363LG0600X
  • Specialization: Gerontology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 50 N PERRY ST
    PONTIAC, MI
    ZIP 48342
  • Phone: (248) 338-5645

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NPI Details

MS. Carly Lynn Kassa is a gerontology nurse practitioner in Pontiac, MI. MS. Carly Lynn Kassa NPI is 1083106140. 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:

50 N PERRY ST
PONTIAC, MI
ZIP 48342-217
Phone: (248) 338-5645
Fax: (248) 338-5547

The NPI 1083106140 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 6/5/2018 and was last updated on 6/5/2018.

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
1363LG0600XNurse PractitionerGerontology4704297338MICHIGANYes

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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