Provider Demographics
NPI:1164907622
Name:CASS, MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:CASS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 NW STATE ROUTE 7
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2726
Mailing Address - Country:US
Mailing Address - Phone:816-229-8880
Mailing Address - Fax:816-229-4363
Practice Address - Street 1:104 NW STATE ROUTE 7
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2726
Practice Address - Country:US
Practice Address - Phone:816-229-8880
Practice Address - Fax:816-229-4363
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018033935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOF09180523OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
MO2018033935OtherMISSOURI STATE BOARD OF NURSING CERTIFIED NURSE PRACTITIONER