Provider Demographics
NPI:1710018783
Name:CRUTCHFIELD, CASSANDRA ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:ELIZABETH
Last Name:CRUTCHFIELD
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 1:8521 SIERRA RIDGE DR
Mailing Address - Street 2:APT. D
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-8516
Mailing Address - Country:US
Mailing Address - Phone:317-270-0522
Mailing Address - Fax:800-675-1132
Practice Address - Street 1:8521 SIERRA RIDGE DR
Practice Address - Street 2:APT. D
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-8516
Practice Address - Country:US
Practice Address - Phone:317-270-0522
Practice Address - Fax:800-675-1132
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist