Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kiersten Rene Carrico, PA-C

Individual provider Physician Assistant · NPI 1508203597

Kiersten Rene Carrico, PA-C is a Physician Assistant in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2013.

Licensed in
IN
In the registry since
2013
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

7950 W Jefferson Blvd Sutie 2121
Fort Wayne, IN 46804-4140
Phone: (260) 435-7937
Fax: (260) 435-7933
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1001557A (IN)

Record details

NPI number1508203597
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 30, 2013
Last updated in NPPESDecember 19, 2024
Certification dateDecember 19, 2024

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