Provider Demographics
NPI:1275174377
Name:PRASAD, CASSANDRA LYNN (NP)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:LYNN
Last Name:PRASAD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:LYNN
Other - Last Name:SEIFERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11504 RAMBLING PINES PL
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-3275
Mailing Address - Country:US
Mailing Address - Phone:315-335-3132
Mailing Address - Fax:
Practice Address - Street 1:11110 MEDICAL CAMPUS RD STE 249
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6756
Practice Address - Country:US
Practice Address - Phone:301-790-8750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV104695363LF0000X
MDR227666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily