Provider Demographics
NPI:1376071787
Name:PYDO, CASSY SUSAN (PA-C)
Entity Type:Individual
Prefix:
First Name:CASSY
Middle Name:SUSAN
Last Name:PYDO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16112 AMSLER RD
Mailing Address - Street 2:
Mailing Address - City:BUTTERNUT
Mailing Address - State:WI
Mailing Address - Zip Code:54514-9122
Mailing Address - Country:US
Mailing Address - Phone:715-762-7311
Mailing Address - Fax:
Practice Address - Street 1:50 SHERRY AVE
Practice Address - Street 2:
Practice Address - City:PARK FALLS
Practice Address - State:WI
Practice Address - Zip Code:54552
Practice Address - Country:US
Practice Address - Phone:715-762-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant