Provider Demographics
NPI:1225690522
Name:MOONEY, CASSANDRA E (MD)
Entity Type:Individual
Prefix:MISS
First Name:CASSANDRA
Middle Name:E
Last Name:MOONEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 NIVEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:YELLOWKNIFE
Mailing Address - State:NWT
Mailing Address - Zip Code:X1A3X5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4915 48TH STREET
Practice Address - Street 2:
Practice Address - City:YELLOWKNIFE
Practice Address - State:NWT
Practice Address - Zip Code:X1A1N2
Practice Address - Country:CA
Practice Address - Phone:867-767-9294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program