Provider Demographics
NPI:1477894756
Name:AMADIO, CASSIE REBECCA (NP-C)
Entity Type:Individual
Prefix:MS
First Name:CASSIE
Middle Name:REBECCA
Last Name:AMADIO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3632 AMERICAN WAY
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-3164
Mailing Address - Country:US
Mailing Address - Phone:307-233-7300
Mailing Address - Fax:307-233-7201
Practice Address - Street 1:3632 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82604-3164
Practice Address - Country:US
Practice Address - Phone:307-233-7300
Practice Address - Fax:307-233-7201
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY21045.1230363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner