Provider Demographics
NPI:1427385772
Name:HAWORTH, CASSANDRA JEANETTE
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:JEANETTE
Last Name:HAWORTH
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 1:320 N SUGAR ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-1655
Mailing Address - Country:US
Mailing Address - Phone:419-953-6361
Mailing Address - Fax:
Practice Address - Street 1:320 N SUGAR ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1655
Practice Address - Country:US
Practice Address - Phone:419-953-6361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.136437-IV164W00000X
OHRN.527015163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse