Provider Demographics
NPI:1700236650
Name:WHITMAN, CASSANDRA KANANI
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:KANANI
Last Name:WHITMAN
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 1:4777 TRAMWAY BLVD NE
Mailing Address - Street 2:APT 119
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2974
Mailing Address - Country:US
Mailing Address - Phone:505-695-0618
Mailing Address - Fax:
Practice Address - Street 1:4777 TRAMWAY BLVD NE
Practice Address - Street 2:APT 119
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2974
Practice Address - Country:US
Practice Address - Phone:505-695-0618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other