Provider Demographics
NPI:1689818676
Name:MCFADDEN, CASSANDRA DEE (RN, LPN)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:DEE
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:RN, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 DURNAN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-4137
Mailing Address - Country:US
Mailing Address - Phone:585-730-1002
Mailing Address - Fax:
Practice Address - Street 1:371 DURNAN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-4137
Practice Address - Country:US
Practice Address - Phone:585-730-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY613992163W00000X
NY290547164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No163W00000XNursing Service ProvidersRegistered Nurse