Provider Demographics
NPI:1649747403
Name:DOSS, CASSANDRA LASHEA (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LASHEA
Last Name:DOSS
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:LASHEA
Other - Last Name:KERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:922 GERALD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-2656
Mailing Address - Country:US
Mailing Address - Phone:573-225-2845
Mailing Address - Fax:
Practice Address - Street 1:3130 E JACKSON BLVD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755-2957
Practice Address - Country:US
Practice Address - Phone:573-243-5095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018039453363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily