Provider Demographics
NPI:1083493340
Name:NOTHSTEIN, CASSANDRA
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:NOTHSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 UNION CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-8649
Mailing Address - Country:US
Mailing Address - Phone:484-629-2413
Mailing Address - Fax:
Practice Address - Street 1:241 PAD FRK
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:WV
Practice Address - Zip Code:25286-9441
Practice Address - Country:US
Practice Address - Phone:484-629-2413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant