Provider Demographics
NPI:1053593988
Name:KASTER, JESSE C (BC HIS)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:C
Last Name:KASTER
Suffix:
Gender:M
Credentials:BC HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 S ANDERSON ST
Mailing Address - Street 2:HEARING ADVANTAGE
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-3448
Mailing Address - Country:US
Mailing Address - Phone:715-362-3711
Mailing Address - Fax:
Practice Address - Street 1:181 S ANDERSON ST
Practice Address - Street 2:HEARING ADVANTAGE
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-3448
Practice Address - Country:US
Practice Address - Phone:715-362-3711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42837100Medicaid