| Casey Kelly, PA | |
|
2200 Tydd St, Eureka, CA 95501-1284 | |
| (707) 269-7051 | |
| (707) 269-7054 |
| Full Name | Casey Kelly |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 2200 Tydd St, Eureka, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205076015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 20196 (California) | Primary |
| Entity Name | Open Door Community Health Centers |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497840656 PECOS PAC ID: 9436067485 Enrollment ID: O20040414000890 |
| Mailing Address | Practice Location Address |
|---|---|
| Casey Kelly, PA 670 9th St, Suite 203, Arcata, CA 95521-6248 Ph: (707) 826-8633 | Casey Kelly, PA 2200 Tydd St, Eureka, CA 95501-1284 Ph: (707) 269-7051 |
Sophia Marie Helena Gutierrez, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2710 Dolbeer St, Eureka, CA 95501 Phone: 707-267-2060 |
Kathryn Stollmeyer, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2321 Harrison Ave, Eureka, CA 95501 Phone: 707-445-3660 |
Shubhangi B Deshmukh, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2725 Myrtle Ave, Eureka, CA 95501 Phone: 800-453-3030 Fax: 800-328-3091 |
Melissa Christine Long, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2700 Dolbeer St, Eureka, CA 95501 Phone: 707-445-8121 |
Mr. Nathaniel Griffith Demay, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2700 Dolbeer St, Eureka, CA 95501 Phone: 707-269-4250 |
Abigail Krause, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2200 Tydd St, Eureka, CA 95501 Phone: 707-441-1624 Fax: 707-441-1253 |
John P Brimlow, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2505 Lucas St, Eureka, CA 95501 Phone: 707-445-3063 Fax: 707-442-6602 |