Provider Demographics
NPI:1326807728
Name:WARNER, CASSANDRA
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 WILSON LN
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-5216
Mailing Address - Country:US
Mailing Address - Phone:304-636-9326
Mailing Address - Fax:
Practice Address - Street 1:67 SIEGAL RD APT 201
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:WV
Practice Address - Zip Code:26253-4685
Practice Address - Country:US
Practice Address - Phone:681-298-8728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant