Provider Demographics
NPI:1376601021
Name:HOUSER, CASSONDRA (CRNP)
Entity Type:Individual
Prefix:
First Name:CASSONDRA
Middle Name:
Last Name:HOUSER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7804 NILE AVE
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-1303
Mailing Address - Country:US
Mailing Address - Phone:610-554-3274
Mailing Address - Fax:
Practice Address - Street 1:7804 NILE AVE
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-1303
Practice Address - Country:US
Practice Address - Phone:610-554-3274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX747120163W00000X, 363LA2200X
ARA03070363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse