Basic Information
Provider Information
NPI: 1124776901
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARNEY
FirstName: CASSANDRA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8558 BROADWAY
Address2:  
City: MERRILLVILLE
State: IN
PostalCode: 464107032
CountryCode: US
TelephoneNumber: 1939270842
FaxNumber: 2197036854
Practice Location
Address1: 1400 S LAKE PARK AVE STE 304
Address2:  
City: HOBART
State: IN
PostalCode: 463426791
CountryCode: US
TelephoneNumber: 2199476638
FaxNumber: 2197036693
Other Information
ProviderEnumerationDate: 03/11/2022
LastUpdateDate: 05/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X28224006AINN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000X71012544AINY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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