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Kacie Jo Costello Moody, PA
Physician Assistant in Fort Mill, South Carolina
NPI 1841461373

Kacie Jo Costello Moody is a Physician Assistant based in Charlotte, SC. Kacie Jo Costello Moody practices in Fort Mill, SC and has the professional credentials of PA. The NPI Number for Kacie Jo Costello Moody is 1841461373 and holds a License No. 0010-00779 (South Carolina).

The current practice location address for Kacie Jo Costello Moody is 704 Gold Hill Rd, Fort Mill, SC and can be reached out via phone at 704-667-3380 and via fax at 704-667-3381. You can also correspond with Kacie Jo Costello Moody through the mailing address at PO BOX 602148, CHARLOTTE, NC - 28260-2148 (mailing address contact number: 704-667-3380).

Location: 704 Gold Hill Rd, Fort Mill, SC, 28260-2148
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1841461373
Provider Name
Kacie Jo Costello Moody
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
704 Gold Hill Rd, Fort Mill, SC, 28260-2148
Phone Number
704-667-3380
Fax Number
704-667-3381
Provider Enumeration Date
03/12/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0640PA 05 SC
1841461373 05 NC
institution
Provider Business Practice Location Address Details
Address
704 Gold Hill Rd
City
Fort Mill
State
South Carolina
Zip
29715-8906
Phone Number
704-667-3380
Fax Number
704-667-3381
person
Provider Business Mailing Address Details
Address
Po Box 602148
City
Charlotte
State
North Carolina
Zip
28260-2148
Phone Number
704-667-3380
Fax Number
704-667-3381
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
-
Taxonomy
363A00000X
License No.
0010-00779 (North Carolina)
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
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