Provider Demographics
NPI:1275238339
Name:CALVIN, CASSANDRA N (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:N
Last Name:CALVIN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:MS
Other - First Name:CASSANDRA
Other - Middle Name:N
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 LANEY WALKER BLVD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2960
Mailing Address - Country:US
Mailing Address - Phone:706-721-5815
Mailing Address - Fax:
Practice Address - Street 1:950 LANEY WALKER BLVD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2960
Practice Address - Country:US
Practice Address - Phone:706-414-1559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN257975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily