Provider Demographics
NPI:1235884735
Name:BATTLE, CASSANDRA D (LPN)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:D
Last Name:BATTLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 N BROADWAY # 485
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-4172
Mailing Address - Country:US
Mailing Address - Phone:866-557-9128
Mailing Address - Fax:
Practice Address - Street 1:18501 NE 63RD ST
Practice Address - Street 2:
Practice Address - City:HARRAH
Practice Address - State:OK
Practice Address - Zip Code:73045-8550
Practice Address - Country:US
Practice Address - Phone:405-454-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0070710164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse