Doctor Name: | KEMA KASALABA |
NPI Number: | 1023377397 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | R199800 |
Business Practice Address: | 1010 Sw Coast Highway Suite 201 Newport, OR - 973655240 |
Business Phone Number: | 5412658816 |
Business Fax Number: | 5412653890 |
Mailing Address: | 1010 Sw Coast Highway Suite 201, NEWPORT |
State: | OR |
Postal Code: | 973655240 |
Phone Number: | 5412658816 |
Fax Number: | 5412653890 |
NPI Enumeration Date: | 05/08/2012 |
NPI Last Update Date: | 05/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R199800 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |