Provider Demographics
NPI:1164817607
Name:DIGBY, CASSANDRA (NP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:DIGBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 OLD WATER WORKS RD SW
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-3353
Mailing Address - Country:US
Mailing Address - Phone:256-979-1250
Mailing Address - Fax:256-979-1251
Practice Address - Street 1:1403 OLD WATER WORKS RD SW
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35968-3347
Practice Address - Country:US
Practice Address - Phone:256-979-1250
Practice Address - Fax:256-979-1251
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-125202363L00000X, 363L00000X
TNAPN20008208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL238202Medicaid