Provider Demographics
NPI:1326459793
Name:BRICKEY, CASSANDRA ANN (RN,IBCLC, RLC)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:ANN
Last Name:BRICKEY
Suffix:
Gender:F
Credentials:RN,IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 VENUS BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:HILTONS
Mailing Address - State:VA
Mailing Address - Zip Code:24258-6585
Mailing Address - Country:US
Mailing Address - Phone:423-930-8209
Mailing Address - Fax:
Practice Address - Street 1:639 VENUS BRANCH LN
Practice Address - Street 2:
Practice Address - City:HILTONS
Practice Address - State:VA
Practice Address - Zip Code:24258
Practice Address - Country:US
Practice Address - Phone:423-930-8209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-19
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001305003163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant