Provider Demographics
NPI:1245795376
Name:LEFEVRE, CASANDRA (RN)
Entity Type:Individual
Prefix:
First Name:CASANDRA
Middle Name:
Last Name:LEFEVRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 MILL ST
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-1511
Mailing Address - Country:US
Mailing Address - Phone:262-384-1359
Mailing Address - Fax:
Practice Address - Street 1:627 MILL ST
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-1511
Practice Address - Country:US
Practice Address - Phone:262-384-1359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-03
Last Update Date:2019-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI222667-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty