Provider Demographics
NPI:1245603646
Name:MONDAY, CASSIE AMANDA (LPN)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:AMANDA
Last Name:MONDAY
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 1:1911 HANCOCK LN
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-0911
Mailing Address - Country:US
Mailing Address - Phone:608-359-8082
Mailing Address - Fax:608-364-0501
Practice Address - Street 1:4537 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WI
Practice Address - Zip Code:53563-8975
Practice Address - Country:US
Practice Address - Phone:608-921-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI319271-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse