Provider Demographics
NPI:1275805004
Name:WHITMORE, CASSANDRA IRENE (RD, LMNT)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:IRENE
Last Name:WHITMORE
Suffix:
Gender:F
Credentials:RD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 278
Mailing Address - Street 2:4800 HOSPITAL PARKWAY, US HWY 77 NORTH
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-6906
Mailing Address - Country:US
Mailing Address - Phone:308-850-1530
Mailing Address - Fax:402-606-4168
Practice Address - Street 1:4800 HOSPITAL PARKWAY, US HWY 77 NORTH
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-6906
Practice Address - Country:US
Practice Address - Phone:402-223-7387
Practice Address - Fax:402-606-4168
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1024133V00000X
1025755133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099131012Medicare PIN