Provider Demographics
NPI:1073212973
Name:MILLER, CASSANDRA (ATC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 VINE ST APT 7
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-2541
Mailing Address - Country:US
Mailing Address - Phone:720-232-7570
Mailing Address - Fax:
Practice Address - Street 1:2504 VINE ST APT 7
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68503-2541
Practice Address - Country:US
Practice Address - Phone:720-232-7570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty